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Acute pharyngitis is an inflammation of the pharynx and surrounding soft tissues caused by viral, bacterial, or fungal infectious agents. Only bacterial and fungal infections require antimicrobial therapy. Over-use of antibiotics can lead to anti-microbial resistance which is concerning. Antimicrobial susceptibility patterns of causative organisms are necessary to guide appropriate treatment. The study aims to retrospectively assess from laboratory records, the antimicrobial susceptibility pattern of pharyngeal isolates amongst children aged below 15 years managed at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. This was a three (3)-year descriptive retrospective review, from January 2022 to December 2024. A convenience sampling technique was used. A review of positive isolates and susceptibility patterns, which were categorized as sensitive, intermediate, and resistant was done. Information was extracted and entered in a study proforma sheet. Data was analyzed using SPSS version 23. A p-value of 0.05 was taken as significant. The total number of patients results reviewed was 305 comprising 160 males (52.5%) and 145 females. The majority 182 (59.7%) were below five (5) years and 109 (35.7%) had positive bacterial and fungal isolates including 50 (16.4%) Streptococcus pneumoniae, 17 (5.6%) Staphylococcus spp., 16 (5.2%) other Streptococcus spp., & 7 (2.3%) Pseudomonas spp. Sixteen (5.2%) had the fungal agent Candida isolated. Streptococcus pneumoniae demonstrated high sensitivity to ciprofloxacin (44%) followed by ceftriaxone (38%) and erythromycin (24%) likewise Staphylococcus spp but resistance to cefotaxime and amoxycillin-clavulanate. Other Streptococcus spp had high sensitivity to ceftriazone (37.5%) but also demonstrated resistance to ciprofloxacin (37.5%) and gentamicin (31.3%). Streptococcus pneumonia, Staphylococcus spp, and other Streptococcus spp were the commonest bacterial pharyngeal isolates and demonstrated mixed sensitivity and resistance to quinolones and cephalosporins antibiotics amongst others. More effort on antimicrobial stewardship is key.