This study was conducted to evaluate the epidemiology and clinical features of bloodstream infections caused by extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) in community-onset bacteremia. Of 929 episodes of community-onset E. coli bacteremia, 4.1% (38/929) had bacteremia with ESBL producers. Of these, 63.2% (24/38) were further classified as healthcare-associated infections. Although most patients had risk factors for infection due to ESBL producers, three patients with urinary tract infection, four patients with cholangitis, and one patient with a liver abscess had no identified predisposing risk factors. The 30-day mortality was 21.1% (8/38). ESBL-EC is a significant cause of bloodstream infection, even in patients with community-onset infection.