This study aimed to evaluate antibiotic prescription knowledge and practices among Oman Medical Specialty Board (OMSB) paediatric residents. The goal was to identify educational opportunities to reduce antimicrobial resistance and improve patient care. A survey-based cross-sectional study was conducted among the OMSB paediatric residents from August 2023 to September 2023. The online survey involved three parts: residents' demographics, knowledge of 12 common paediatric infection scenarios and clinical practice. Participants were asked to choose the proper antibiotic choices and duration for each scenario. Data analysis was performed using SPSS. A total of 74 responses were obtained, resulting in an 84% response rate. No significant differences were observed in the knowledge of antibiotic prescriptions among paediatric residents at different stages of their residency. The highest knowledge-based adherence rate to local antibiotic guidelines was noted in the acute sinusitis scenario (n = 70; 94.6%), followed by the acute meningitis scenario (n = 68; 91.9%). Conversely, the lowest adherence was observed in the acute otitis media (n = 16; 21.6%), followed by cellulitis (n = 23; 31.1%). Residents exhibited proficient clinical judgement by consulting infectious disease specialists when required based on the scenarios provided. The low knowledge-based adherence to antibiotic guidelines for common paediatric infections, coupled with the lack of significant differences in antibiotic knowledge between senior and junior paediatric residents, underscores the need for collective educational interventions. These interventions aim to advance knowledge and skills in antimicrobial stewardship and local antibiotic guidelines application.