Background: AST guide both patient management and national AMR surveillance. In Cameroon, laboratories interpret AST using either CLSI or EUCAST standard which may not always give the same conclusion for every case. This study compared EUCAST 2025 and CLSI 2025 interpretations of identical disk diffusion results at Buea Regional Hospital (BRH). Methods: This was a retrospective laboratory-based study where raw inhibition zone diameters of Enterobacterales, Staphylococcus and Pseudomonas isolates recorded in the BRH WHONET database (2023 – 2025) were interpreted with EUCAST 2025 and CLSI 2025 standards. Agreement was evaluated using Cohen’s kappa (κ), with κ < 0.61 considered poor agreement. Major interpretation switches (susceptible ↔ resistant) were enumerated, and the standard more associated with non-susceptible outcome was identified using the exact McNemar test. Results: A total of 1,198 isolates (748 Enterobacterales, 367 Staphylococcus and 83 Pseudomonas ) were included in the analysis. Poor agreement was observed for 4/12 (33.3%) antibiotics against Enterobacterales (lowest: ofloxacin, κ = 0.48), 5/10 (50%) against Staphylococcus (lowest: levofloxacin, κ = 0.08) and 5/7 (71.4%) against Pseudomonas (lowest: cefepime and imipenem, κ = 0.24). Major interpretation switches occurred for 3/12 antibiotics (Amox/clavulanic acid [1.1%], ceftriaxone [0.6%] and ofloxacin [15.6%]) against Enterobacterales, 6/10 against Staphylococcus (minocycline [21.1%], gentamicin [15.9%], rifampicin [14.4%], clindamycin [2.7%], tetracycline [4.5%], levofloxacin [13.7%]) and 2/7 among Pseudomonas (cefepime [20%], ciprofloxacin [3%]). Overall, EUCAST was significantly more likely (p < 0.001) to classify isolates as non-susceptible. Conclusion: Poor agreement between EUCAST 2025 and CLSI 2025 affected one third of the antibiotics tested for Enterobacterales, half for Staphylococcus and close to three quarters for Pseudomonas . Major interpretation switches were quite common for levofloxacin, ofloxacin, gentamicin, minocycline, rifampicin and cefepime. EUCAST was generally more likely to classify isolates as non-susceptible. A single national breakpoint standard is recommended in Cameroon so as to optimize the reliability of its surveillance data.