Antimicrobial resistance data forNeisseria gonorrhoeaeis globally sparse and resistant strains are emerging in Catalonia. We aim to describe epidemiological and antimicrobial resistance in all patients infected withN. gonorrhoeaeduring the period from 2016 to 2019, using available antimicrobial susceptibility data. We retrospectively analysed confirmedN. gonorrhoeaecases notified to Catalonia’s microbiological reporting system. Antibiotic susceptibility testing (azithromycin, cefixime, ceftriaxone, ciprofloxacin, penicillin, spectinomycin, and tetracycline) was assessed using clinical breakpoints published by the European Committee on Antimicrobial Susceptibility Testing. Incidence rates were calculated and proportions were compared using the χ2test or Fisher’s exact test, and analysed using the Statistical Package for Social Sciences (SPSS 18.0). A total of 14,251 confirmed cases ofN. gonorrhoeaewere notified. Incidence increased from 30.7 cases/100,000 person-years (p< 0.001) in 2016 to 64.7 in 2019. Culture was available in 6,292 isolates (44.2%), of which 5,377 (85.5%) were resistant to at least one of the antibiotics tested. Azithromycin resistance rose from 6.1% in 2016 to 16% in 2019 (p< 0.001). Only 1.0% (45 cases) were resistant to ceftriaxone. Multidrug-resistantN. gonorrhoeaeincreased from 0.25% in 2016 to 0.42% in 2019 (p= 0.521). One case presented extensively drug-resistantN. gonorrhoeae. In Catalonia, 10% of theN. gonorrhoeaeisolates were resistant to azithromycin in the 2016–2019 period. According to World Health Organization guidelines, resistance above 5% indicates an alert to review treatment guidelines. Antimicrobial susceptibility testing in clinical practice followed by surveillance and interventions are essential to monitor trends and prevent the spread of antimicrobial resistance.