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ABSTRACT: Lamb diarrhea seriously restricts the development of the sheep industry. Infectious pathogens often cause diarrhea, and E. coli isolates are highly distributed in infectious diarrhea. The study aimed to investigate the prevalence of pathogenic E. coli in diarrhea lambs and determine the distribution of virulence genes, antibiotic resistance genes, and antibiotic resistance. One hundred seventy-eight E. coli isolates were isolated from the feces of 204 diarrhea lambs. The virulence genes mdh, hlyF, iss, ompA, fimC, iucD, st, lt, stx1, stx2, and antibiotic resistance genes including tetA, tetB, aac (6′)-II, blaCMY-2, qnr, aadA1, sul1, blaTEM, blaCTX-M were detected by polymerase chain reaction (PCR). Antibiotic resistance was determined by Kirby-Bauer Disc Diffusion method. There were 109 (61.24%, 109/178) enterotoxigenic E. coli (ETEC), 119 (66.85%, 119/178) Shiga toxin-producing E. coli (STEC), and 95 (53.37%, 95/178) hybrid STEC/ETEC isolates. The highest prevalent virulence genes were ompA (80.90%, 144/178) and fimC (67.98%, 121/178), and the lowest was iucD (8.99%, 16/178). The most commonly detected antibiotic resistance genes were tetA/tetB (92.70%, 165/178), qnr (75.84%, 135/178), and sul1 (62.92%, 112/178), no blaTEM or blaCTX-M genes were detected. All isolates had high antibiotic resistance to lincomycin (96.63%, 172/178), tetracycline (88.76%, 158/178), and co-trimoxazole (80.34%, 143/178), and the multidrug resistant (MDR) rate reached 93.82% (167/178). The high prevalence of ETEC and STEC indicates that E. coli is one of the critical pathogenic agents leading to diarrhea in lambs in the region, and its high antibiotic resistance, especially MDR, should be brought to our attention.