Bacterial vaginosis is a common condition affecting women of reproductive age, caused by an imbalance in the vaginal microbiome. This study identifies the pathogens causing bacterial vaginosis in Nineveh and evaluates their antibiotic sensitivity to determine effective treatments. Key pathogens include Staphylococcus aureus, Escherichia coli, Gardnerella vaginalis, Klebsiella spp., and Candida spp. The results highlight significant antibiotic resistance, particularly to Ampicillin and Amoxicillin, and high sensitivity to Meropenem, Ciprofloxacin, Gentamycin, and Amikacin. The vaginal microbiome plays a protective role, dominated by Lactobacillus. Bacterial vaginosis disrupts this balance, leading to overgrowth of anaerobic or facultative bacteria. It is associated with abnormal discharge, discomfort, and health complications, such as increased susceptibility to sexually transmitted infections, pregnancy-related issues, and neonatal infections. 40 vaginal swabs from women aged 20-42 years in Mosul. Swabs were analyzed microscopically and cultured on various media (e.g., blood agar). Gram staining and biochemical tests identified microbial species, confirmed with the Vitek2 system. The Kirby-Bauer disc diffusion method tested 22 antibiotics for effectiveness against isolated bacteria. Staphylococcus aureus (42.5%) dominant isolate. Escherichia coli (12.5%), Gardnerella vaginalis (5%), and Klebsiella spp. (2.5%). Candida spp. (37.5%) often found in mixed infections. High resistance to Ampicillin, Amoxicillin, and Ceftazideme. Effective antibiotics include Meropenem, Ciprofloxacin, Gentamycin, and Amikacin. The study emphasizes the necessity of tailored antibiotic treatments to combat resistance and prevent complications.