The review discusses the global challenge posed by multidrug-resistant *Acinetobacter baumannii*, a nosocomial pathogen that has emerged as a significant threat due to its resistance to multiple antibiotics. *A. baumannii* is found in healthcare environments and is highly resilient, making it a successful pathogen. The review highlights the increasing global emergence of MDR *A. baumannii* and its spread through outbreaks in various regions. The mechanisms of resistance to selected antibiotics, such as beta-lactams, aminoglycosides, quinolones, tetracyclines, and polymyxins, are detailed. The genetic basis of antibiotic resistance, including the presence of resistance islands and mobile genetic elements, is also discussed. The review examines the implications for diagnosis and treatment, emphasizing the challenges in susceptibility testing and the limited options for therapy. It suggests combination therapy as a strategy to enhance efficacy and discusses the use of colistin, tigecycline, and other antibiotics. Finally, the review outlines perspectives on controlling MDR *A. baumannii*, including infection control measures, molecular tools for outbreak investigation, and the development of new antimicrobials and vaccines.The review discusses the global challenge posed by multidrug-resistant *Acinetobacter baumannii*, a nosocomial pathogen that has emerged as a significant threat due to its resistance to multiple antibiotics. *A. baumannii* is found in healthcare environments and is highly resilient, making it a successful pathogen. The review highlights the increasing global emergence of MDR *A. baumannii* and its spread through outbreaks in various regions. The mechanisms of resistance to selected antibiotics, such as beta-lactams, aminoglycosides, quinolones, tetracyclines, and polymyxins, are detailed. The genetic basis of antibiotic resistance, including the presence of resistance islands and mobile genetic elements, is also discussed. The review examines the implications for diagnosis and treatment, emphasizing the challenges in susceptibility testing and the limited options for therapy. It suggests combination therapy as a strategy to enhance efficacy and discusses the use of colistin, tigecycline, and other antibiotics. Finally, the review outlines perspectives on controlling MDR *A. baumannii*, including infection control measures, molecular tools for outbreak investigation, and the development of new antimicrobials and vaccines.