Multidrug-resistant Pseudomonas aeruginosa, which was only susceptible to colistin, was isolated from the urine of a patient with pyelonephritis. The isolates were confirmed as class A Extended-spectrum-β-lactamase-producing isolates. A blaBEL allele was detected by multiplex polymerase chain reaction. The organisms were identified as ST235, serotype O11. Chinese herbal decoction was orally administered. The patient returned 8 days later with relief of symptoms. No P. aeruginosa was isolated from two urine samples taken after 1 week and 2 weeks from the end of herbal therapy. The case supports the notion that these Chinese herbs are useful in treating pyelonephritis caused by multidrug-resistant P. aeruginosa. Chinese herbal medicine has allowed another choice of treatment.