Introduction: Body image (BI) is a multidimensional concept, with behavioral, psychological and cultural components. Objectives: to describe body image perception and satisfaction among university students, to identify factors affecting body image perception and satisfaction and to determine the relation between body image perception, satisfaction, and self-esteem. Methods: A cross sectional study was conducted among 400 university students from Ain shams university and Misr University for Science and Technology (MUST). Self-administered questionnaire was used including questions about socio-demographic factors like age and gender, body image figure scale to measure body image perception and satisfaction, scale to measure body image concerns and Rosenberg scale of self-esteem. Body weight and height were also measured to calculate BMI. Results: 400 students participated in the study, 206 (51.5%) from Ain Shams University and 194 (48.5%) from MUST University. Their mean age was 20.6 ± 2.2 years, 254 (63.5%) were females. Females preferred significantly smaller figures on figure scale as their ideal male body figure and smaller body figures for their own gender they think males would prefer. Measurement of body image satisfaction showed that 221 (55.25%) participants wanted to lose weight, 123 (30.75%) satisfied with their body weight, and 56 (14%) wanted to gain weight. 333 (83.2%) participants had positive BI concerns and 366 (91.5%) showed high self-esteem. There was a statistically significant positive correlation between self-esteem score and body image concerns scale. Conclusion: The majority of University students perceived their body status as normal and preferred average body shapes as their ideal for their gender and other gender. More than half of the student underestimated their body image so; innovative strategies are required to ensure better appreciation of the actual body size and understanding of the health consequences of overweight and obesity and to reverse the acceptance for larger body size.