Background: lean management and clinical governance as solutions for quality health care require rigorous consideration of the essential success factors for their adoption. Aim: To assess the level of the Success Factors Key for Lean management practice and clinical governance climate implementation as perceived by nurse managers at selected hospitals. Methods: Descriptive, comparative, research design was used and was conducted in two selected hospitals in Egypt; namely, Menoufia University Hospital and Benha University Hospital on all nurse managers in the different managerial levels from each of the selected hospitals were included (no= 152). by using two tools, Lean Management Practice Questionnaire and Clinical Governance Climate Questionnaire Results: The level of the success factors key of Lean management in Menoufia University Hospital and Benha University Hospital was moderate level, the level of the Success Factors Key of clinical governance at Menoufia University Hospital was low level while in Benha University Hospital was moderate level. Additionally, the majority of the nurse managers in both study settings moderately perceived the success factors key for lean management practice and clinical governance climate implementation. Conclusion: There was a statistically significant correlation of success factors key for Lean management practice and clinical governance climate implementation in both study settings. Recommendations: Developing a strategy for lean management integrating clinical governance is recommended as a quality improvement initiative in health care organizations