Background: Urinary tract infection in the form of asymptomatic or symptomatic disease is common during pregnancy and may cause obstetric complication that can be avoided by antibiotic treatment. Significant controversy is present in the published literature about the proper antibiotic and the sufficient duration to treat urinary tract infection during pregnancy. Objective of the study: To investigate the efficacy of fosfomicin in treating urinary tract infection in a sample of pregnant women in their second trimester. Patients and methods: Seventy pregnant women with urinary tract infection were enrolled in the current cross sectional study. They were classified into two groups; one given single dose fosfomicin and the other given cefuroxime. Results: The cure rate using fosfomicn was comparable to the cure rate of cefuroxime, 85.7% versus 91.4%, with no statistical difference. No intolerable adverse effects were reported after using fosfomicin. Conclusion: Single dose fosfomicin is efficient, safe, well tolerated antibiotic treatment for UTI in pregnant women during second trimester.