Rationale: Reproductive tract infections (RTIs), including pelvic inflammatory disease (PID), are significant public health concerns among young women, especially in sub-Saharan Africa. The university environment, characterized by communal living and varying access to personal healthcare, provides a unique setting to investigate these infections. Understanding the prevalence, microbial patterns, and antimicrobial resistance in university settings is critical to developing effective health interventions. Objectives: This study aimed to assess the prevalence of RTIs, identify the microbial pathogens responsible for pelvic inflammatory disease, and determine their antimicrobial susceptibility patterns among female students residing in hostels at Niger Delta University, Bayelsa State, Nigeria. The study also sought to explore the age distribution of affected individuals and the microbial burden in the university hostel environment. Methods: A descriptive cross-sectional study was conducted at Niger Delta University in Amassoma, Nigeria. Fifty female students within the reproductive age group residing in the university’s hostels participated. Data were collected using high vaginal swabs and midstream urine samples, which were cultured for microbial growth. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method. Descriptive statistical analysis was employed to present the findings. Results: The study found that 52% of participants were in the 18–21 age group, while 48% were in the 22–25 age group. Candida species were the most commonly isolated pathogens (70%), followed by Escherichia coli (30%). The growth rates on Sabouraud dextrose agar revealed a predominance of fungal infections. Antimicrobial susceptibility testing showed varying levels of resistance, with Ciprofloxacin and Levofloxacin exhibiting the highest susceptibility, while higher resistance rates were observed for commonly used antibiotics such as Amoxicillin and Augmentin. Conclusion: The findings suggest that fungal infections, particularly those caused by Candida species, are a significant concern among young female university students. The presence of antimicrobial resistance highlights the need for alternative treatment strategies and enhanced infection control measures. Recommendations: Implement hygiene education and improved sanitation in hostel facilities, introduce routine screening for RTIs and provide access to effective antimicrobial treatments and integrate reproductive health education and regular medical check-ups into the university’s healthcare services. Health Significance: This study underscores the importance of addressing RTIs among young women in university settings to prevent long-term reproductive health issues. The findings contribute to the understanding of microbial resistance patterns, which is essential for the development of effective public health policies and interventions targeting PID and associated complications such as infertility.