Vibrio cholerae is a prominent global health threat, primarily due to its association with cholera outbreaks and the rising challenge of antimicrobial resistance (AMR). This paper focuses on the microbial pathogenesis of Vibrio cholerae, elucidating the complex interplay between virulence factors, host immune evasion, and environmental and socio-economic determinants that exacerbate cholera transmission. Fundamental mechanisms of pathogenesis include the production of cholera toxin, the formation of biofilms, and the utilization of sophisticated secretion systems, which facilitate the colonization and disease induction. Concurrently, the mechanisms underlying antimicrobial resistance in Vibrio cholerae are explored, highlighting enzymatic degradation, efflux pumps, and genetic resistance factors that complicate treatment efforts. The increasing prevalence of resistant strains necessitates robust surveillance and the development of alternative therapeutic strategies, such as phage therapy and probiotics. Combining public health strategies, environmental management, and innovative research, this integrated approach is essential for effectively controlling cholera and mitigating AMR impacts. By enhancing an understanding of Vibrio cholerae pathogenesis and resistance trends, this paper aims to contribute to developing sustainable interventions and improving public health outcomes globally.