The carbapenem/beta-lactamase inhibitor (meropenem-vaborbactam; MEV) used to treat complicated urinary tract infections and pyelonephritis in adults was approved in 2017 by the U.S. Food and Drug Administration (FDA). We evaluated VITEK 2 MEV (bioMérieux, Durham, NC) compared to the reference broth microdilution (BMD) method. Of 449
Enterobacterales
isolates analyzed per FDA/CLSI breakpoints, overall performance was 98.2% Essential Agreement (EA), 98.7% Category Agreement (CA), and 0% Very Major Errors (VME) or Major Errors (ME). For FDA intended for use 438
Enterobacterales
isolates, performance was 98.2% EA, 98.6% CA, and 0% VME or ME. Evaluable EA was 81.0% but with only 42 on-scale evaluable results. Individual species demonstrated EA and CA rates ≥ 90% without any VME or ME. When evaluated using European Committee on Antimicrobial Susceptibility Testing (EUCAST) breakpoints, overall VITEK 2 MEV performance for
Enterobacterales
and
Pseudomonas aeruginosa
demonstrated 97.3% EA, 99.2% CA, 2.3% VME, and 0.6% ME (after error resolution: 97.3% EA, 99.4% CA, 2.2% VME, and 0.4% ME) compared to the reference BMD method. Performance for
P. aeruginosa
included 92.2% EA, 97.4% CA, 0% VME, and 3.0% ME (after error resolution: 92.2% EA, 98.7% CA, 0% VME, and 1.5% ME). Performance for
Enterobacterales
included 98.2% EA, 99.6% CA, 3.0% VME, and 0.2% ME. Evaluable EA was 80.6% but due to only 67 evaluable results. These findings support VITEK 2 MEV as an accurate automated system for MEV susceptibility testing of
Enterobacterales
and
P. aeruginosa
and could be an alternate solution to the manual labor intensive reference BMD method.