Extraintestinal pathogenic E. coli (ExPEC) strains are associated with causing a wide range of infections such as urinary tract infections and bacteraemia. Over the past two decades, the levels of antimicrobial resistance of ExPEC strains have increasingly been reported worldwide, and this is attributed to the global emergence and dissemination of a single ExPEC lineage, known as E. coli ST131. This review explored the current knowledge of E. coli ST131 in Saudi Arabia, focusing on its antimicrobial resistance, virulence capacity and metabolic potential. Many local reports have shown that the antimicrobial resistance levels of E. coli ST131 were higher than non-ST131, particularly to front-line agents used for the empirical treatment of infections caused by ExPEC. Furthermore, E. coli ST131 strains have been associated with high virulence capacity, which could drive the current success of this clone locally. The metabolic activity of ST131 was also found to be slightly higher than non-ST131 strains that obtained from blood population. Taken together, the future studies should focus on elucidating the factors that drive the success of ST131.