Antimicrobial resistance is a global crisis which requires urgent action to halt its spread. The rate of deaths due to antibiotic resistance from bacterial infection reached 25,000 annually. Resistance rates to Escherichia coli and Klebsiella pneumoniae has risen to reach 40% and 56% respectively, in addition to high resistance rates of Acinetobacter baumannii to fluroquinolones and other antibiotics that reached 56%. So it has become an urgent need to establish robust programs to control antibiotic resistance and optimize the use of antibiotics in hospitals. In Egypt particularly, the rate of antibiotic resistance becomes high due to wrong traditions of dispensing and administration antibiotics in hospitals and pharmacies, all that drove us to build a program controlling all these obstacles. Antimicrobial stewardship programs (ASPs) are strategic programs to prevent development of microbial resistance and monitor prescription patterns of clinicians inside hospitals. In addition to minimize the toxic effects, overuse of antibiotics and improve the patient health, and minimize the emergence of antibiotic resistance in shadow of the lack of development of novel antimicrobial agents. In this review, we aimed to discuss antimicrobial stewardship programs, their core elements, clinical importance, essential requirements and their implementation in Egypt. In conclusion, the development of national guidelines for antimicrobial stewardship programs would be a useful step to help clinicians in making evidence-based treatment choices regarding antibiotic therapy and implementation of better antibiotic during pandemics. We hope this review help the medical staff to perform stewardship programs to control the antibiotic resistance in Egypt healthcare settings.