This study aimed to estimate the prevalence of Toxoplasma gondii oocyst (Tgo) shedding among cats and T. gondii recent infection among pregnant women in Gharbia Governorate, Nile Delta, Egypt, to assess T. gondii infection at the cat-human interface. Copro-PCR, targeting the B1 gene, showed that 22.7% (384/1,694) of the examined cats were shedding Tgo. The prevalence rates among stray and pet cats were 27.8%, and 6.8%, respectively; stray cats were 4.08 times more likely to shed Tgo than pet cats. Among stray cats, the odds of Tgo shedding were higher in feral cats feeding on wet market garbage than in semiferal cats that received daily meals from some households in the region (odds ratio (OR) 32.4; P < 0.001). For pet cats, access to kitchens and outdoors were risk factors for Tg infection (OR: 4.9–12.1; P < 0.001 - 0.046), whereas routine checkups at vets were a protective practice (OR: 0.3; P 0.03). The seroprevalence of T. gondii recent infection (positive for anti-T. gondii IgM) among pregnant women was 8.8% (35/400). Only 47.9% of pet owners knew that cats could transmit zoonotic pathogens to humans, whereas 35.7% had heard about toxoplasmosis. Pet owners who did not wear gloves while removing cat excreta and those with actively infected cats were 8.4 and 18.7 times more at risk of contracting T. gondii infection than other pet owners (P <0.05). Garbage hygienic disposal at wet markets, stray cat sheltering and health education for pet owners are compelling measures for preventing toxoplasmosis in Egypt.