Azima tetracantha L., a medicinal plant from the Salvadoraceae family, is traditionally recognized for its diverse therapeutic properties, including antimicrobial, anti-inflammatory, hepatoprotective, and hypoglycemic effects. This study aimed to screen the phytochemical constituents and evaluate the antimicrobial potential of its leaf extracts. The phytochemical analysis revealed the presence of key bioactive compounds such as tannins, flavonoids, phenolic compounds, lignin, and terpenoids in ethyl acetate and ethanol extracts. The antimicrobial activity was assessed using the disc diffusion method against various bacterial (Escherichia coli, Pseudomonas aeruginosa, Streptococcus mutans, Salmonella typhi, and Staphylococcus epidermidis) and fungal (Aspergillus niger, Aspergillus flavus, and Candida sp.) strains. The ethanol extract demonstrated the highest inhibition against Escherichia coli (11 mm), Streptococcus mutans (11 mm), and Staphylococcus epidermidis (12 mm). The ethyl acetate extract exhibited notable inhibition against Escherichia coli (8 mm) and Staphylococcus epidermidis (6 mm). The diethyl ether extract showed strong inhibition against Escherichia coli (12 mm) but was less effective against other bacterial strains. Petroleum benzene extract exhibited limited activity, with inhibition observed only against Streptococcus mutans (7 mm). Mixed solvent extracts displayed the highest inhibition against Escherichia coli (20 mm), Streptococcus mutans (20 mm), Staphylococcus epidermidis (15 mm), and Candida sp. (16–20 mm). GC-MS analysis identified several bioactive metabolites, further highlighting the pharmaceutical potential of Azima tetracantha L. The findings support its traditional medicinal use and suggest its potential role in developing novel antimicrobial agents.