Background: Pre-discussion of goals of care especially at the end of life in dementia is not a common practice in Egypt. Aim: The aim of the current study is to determine caregivers' perspectives towards goals of care and end-of-life issues in moderate to severe and severe dementia patients. Methods: A questionnaire was applied to 101 caregivers about the perspectives of caregivers of moderate to severe and severe dementia patients toward goals of care and end-of-life issues. Results: No one of the caregivers had previous training for dementia care or discussed dementia care goals or end-of-life issues with healthcare providers. Perspectives towards goals of care were 60.4% preferred decreasing patient suffering, and 39.6% preferred preserving patient function. No one chose life prolongation as a goal of care. Regarding end-of-life care, 98% of caregivers accepted mechanical ventilation, 90.1% accepted using painkillers, 74.3% accepted using a feeding tube and 97% accepted CPR at a late stage. There was a significant relation between the duration since dementia was diagnosed (>1 year) and choosing a nursing home for sleep problems and feeding problems. Conclusions: Egyptian caregivers' perspectives towards goals of care and end-of-life issues chose to decrease the suffering of patients and improve their quality of life rather than prolong their life span in the late stages of dementia. Educational level and caregivers' relation with the patients didn't influence caregivers' perspectives towards end-of-life issues yet it slightly affected the goals of care.