Pseudomonas aeruginosa is an opportunistic pathogen that causes severe infections in immunocompromised individuals, particularly in cystic fibrosis (CF) patients and hospital-acquired infections. It is known for its ability to adapt, survive, and persist in various environments, often leading to life-threatening infections. This review highlights the diverse mechanisms by which P. aeruginosa survives and persists, including regulatory networks, quorum sensing (QS), biofilm formation, and antibiotic resistance. QS is a key regulatory system that controls gene expression in response to environmental cues, enabling the bacterium to switch between different lifestyles. QS systems regulate the production of virulence factors, biofilm formation, and antibiotic resistance, which are crucial for survival and persistence. The review also discusses the role of QS in mediating responses to various stresses, such as host immune factors, nutrient depletion, and environmental changes. Additionally, the review covers the composition and structure of P. aeruginosa biofilms, which provide protection against antibiotics and host immune responses. The review also discusses the mechanisms of antibiotic resistance in P. aeruginosa, including intrinsic resistance, acquired resistance, and adaptive resistance. These mechanisms allow the bacterium to survive antibiotic treatments and persist in the host. The review emphasizes the need for collaborative international efforts to develop strategies to prevent and treat P. aeruginosa infections while reducing antibiotic resistance.Pseudomonas aeruginosa is an opportunistic pathogen that causes severe infections in immunocompromised individuals, particularly in cystic fibrosis (CF) patients and hospital-acquired infections. It is known for its ability to adapt, survive, and persist in various environments, often leading to life-threatening infections. This review highlights the diverse mechanisms by which P. aeruginosa survives and persists, including regulatory networks, quorum sensing (QS), biofilm formation, and antibiotic resistance. QS is a key regulatory system that controls gene expression in response to environmental cues, enabling the bacterium to switch between different lifestyles. QS systems regulate the production of virulence factors, biofilm formation, and antibiotic resistance, which are crucial for survival and persistence. The review also discusses the role of QS in mediating responses to various stresses, such as host immune factors, nutrient depletion, and environmental changes. Additionally, the review covers the composition and structure of P. aeruginosa biofilms, which provide protection against antibiotics and host immune responses. The review also discusses the mechanisms of antibiotic resistance in P. aeruginosa, including intrinsic resistance, acquired resistance, and adaptive resistance. These mechanisms allow the bacterium to survive antibiotic treatments and persist in the host. The review emphasizes the need for collaborative international efforts to develop strategies to prevent and treat P. aeruginosa infections while reducing antibiotic resistance.