Although the informed consent process is considered a standard procedure for informing patients about their plan of care, benefits, risks and alternatives of treatment in developed countries; it often fails to meet its goal in many developing countries. Goal: to improve the quality of the informed consent process in general surgical departments at the Faculty of Medicine, Cairo University Hospitals. Specific objectives: evaluating the differences in knowledge, practice and perception between physicians and patients and setting recommendations to improve this process. Subjects and methods: A cross-sectional study was conducted on a total of 172 physicians and 216 elective adult patients who completed a voluntary multiple-choice questionnaire. Results: A significantly higher percent of physicians as compared to patients (73.8% vs. 27.3%, P< 0.001) reported being fully acquainted with the informed consent process. Nearly half of the physicians (49.4%) reported that they informed patients about their medical condition in details, while 38.9% of patients reported that they have been informed about their medical condition in details (P<0.001). A significantly higher percent of physicians as compared to patients reported that they explained to their patients the possible complications of their planned treatment in details (50% vs. 18.5%, P<0.001). Professors had a significantly higher (P<0.001) practice score compared to lecturers and residents regarding nearly all items about obtaining the surgical consent form. Conclusion: Significant differences were found between physicians and patients regarding their knowledge, practice and perception of the informed consent process which highlight the need for establishing better communication channels. Providing educational programs to patients and junior physicians is mandatory to fill the knowledge gaps and improve the quality of this process.