This study examines the role of governance in improving the quality of health services in Egypt, with particular attention to the influence of both internal and external factors. Focusing on hospitals in Alexandria as a case study and combining descriptive analysis with field research, it explores how various health service providers work to enhance service delivery. The study analyzes the institutional, operational, and contextual challenges faced by medical organizations and evaluates the extent to which governance in the health sector supports the goals of Egypt's Vision 2030. The findings indicate that Egypt's health system requires substantial reform and that the success of ongoing initiatives, including the Comprehensive Health Insurance System, depends on profound institutional and resource-related transformations. The study concludes with a set of recommendations for the effective implementation of current health sector reforms.