An NDM-1 carbapenemase-producing Escherichia coli isolate of sequence type 131 (ST131) that belonged to phylogenetic group B2 was obtained from a patient with a urinary tract infection who returned to the United States after a recent hospitalization while visiting India. NDM-1-producing E. coli ST131 had significantly more virulence factors than NDM-1-producing E. coli ST101, previously isolated from a patient in Canada. The presence of NDM β-lactamases in a very successful and virulent E. coli sequence type is of concern.