Bacteriuria in paediatric oncology patients have not been well studied. This retrospective study analysed clinical features, distribution and antimicrobial susceptibility of bacterial pathogens cultured from urine in paediatric oncology patients over a 4-year period (2019-2022). A total of 143 episodes of bacteriuria were documented in 74 patients. Neutropenia was present in 17.5% (25/143), symptoms in 25.9% (37/143) and urinary catheter in 7.0% (10/143) episodes. Symptomatic bacteriuria episodes were statistically significantly more frequent in patients with neutropenia ( = 0.0232). The most common bacterial pathogens were (n = 49; 32.2%), spp. (n = 34; 22.4%), (n = 22; 14.5%) and spp. (n = 21; 13.8%). Extended-spectrum β-lactamases-producing (ESBL) Enterobacterales were found in 11 episodes (11/143; 7.7%) with the highest proportion among isolates (n = 7/34; 20.6%). No carbapenem-resistant Enterobacterales, multidrug-resistant or vancomycin-resistant spp. were found. The most important novelties are demonstrating as one of the prominent bacteriuria pathogens in this patient population, presence of ESBL isolates and carbapenem-resistant later during hospitalization highlights the need for appropriate antimicrobial treatment. However, because of the small number of symptomatic patients, further studies are needed to clarify the importance of including urine culture in the diagnostic process in patients with febrile neutropenia.