Pseudomonas aeruginosa is known as an important opportunistic pathogen, resistant to a high number of antibiotics. Efflux pumps are one of the main intrinsic antibiotics resistance mechanisms in P. aeruginosa. MexAB-OprM, MexCD-OprJ, and MexXY-OprM are the main efflux pumps involved in beta-lactam resistant strains which may cause cross resistance to different antimicrobial classes. The aim of this study was to detect relative gene expression in betalactam-resistant clinical P. aeruginosa strains. One hundred fourteen clinical strains of P. aeruginosa were identified by phenotypic and genotypic methods. Antibiotic susceptibility testing was conducted according to CLSI guideline. Carbonyl cyanide 3-chlorophenylhydrazone (CCCP) was used as an efflux pump inhibitor for phenotypic detection of efflux pump mechanism and q-RT PCR was conducted for relative gene expression detection. The highest rate of resistance was observed against cefotaxime and various relative gene expressions levels were observed in all isolates with positive phenotypic test results.