Abstract The increasing healthcare costs have forced the healthcare managers to know the cost of different alternatives approaches to providing care. This study aims to estimate the costs of general surgical operating theater services at Assuit University Hospital. Subject& Methods: Subjects of the study included three types :-( patient's records, surgeons, and nurses).The total subjects of this study (Total number=280 patients records), the records of this study scheduled for surgery as follows: Major, Minor, and Technically Advanced Operations. Data collection: was done by using: Retrospective Review Tool of operations Performed in Year (2011) , Monitoring Form for Operating Theater" to record activities performed by nursing staff and auxiliary; and Costing and Pricing List Form for Surgical Procedures in Operating theater. Results: direct (variable, fixed) costs and indirect costs were higher for major and technically advanced operations than minor operations. The minor, major operations done under spinal anesthesia were less in their total basic direct variable cost. indirect costs for all surgeries, anesthesia, nursing and operating theaters represents the highest costs among the (indirect costs) for technically advanced operations than in major and minor operations. Recommendations: Increase awareness of nurses about the importance of calculates the cost to maintain cost reduction. Proper utilization of operating theater time by using an organized surgeries list and coordinating activities between the surgical departments and operating theater to reduce the surgery's waiting time. In-service training programs for newly employed nursing personnel about operating theater services