The occurrence of multiple antibiotic-resistant pathogens is steadily increasing, and their presence is not limited to clinical settings as they are also encountered in the environment. Horizontal gene transfer is a crucial means of generation and spread of multiresistant pathogenic bacteria. It is subdivided into three different mechanisms: conjugation (conjugative transfer), transformation, and transduction, of which conjugative transfer of plasmids and integrative conjugative elements (ICE) is the most important one. In 2017, the World Health Organization (WHO) published a list of antibiotic-resistant bacterial pathogens for which alternative drugs or treatments need to be urgently developed. Here, we review the spread and transfer mechanisms of these antibiotic resistances and end with current approaches, which could aid in tackling them.