This study aimed to identify the extent of evaluating the expected economic and environmental returns for applying total quality management in the health sector - by applying it to Ain Shams University hospitals, To achieve this goal, the researchers relied on theoretical grounding through the inductive approach, from Arabic and foreign books, references, and studies, and then conducted a field study by designing a survey list for employees at Ain Shams University Hospitals, including administrators, health service providers, and members of the quality team at some Ain Shams University Hospitals, This is with the aim of obtaining scientific and logical answers from that sample, and analyzing it statistically to link the theoretical study with the practical reality in some Ain Shams University hospitals, and arriving at an assessment of the expected economic and environmental return for applying total quality management in the health sector - by applying it to Ain Shams University hospitals. The study concluded that there was no fundamental relationship between total quality management and continuous improvement of performance, which was formulated in the form of null, and the alternative hypothesis was accepted. A direct statistically significant relationship was found between the application of total quality management and continuous improvement of performance. The results of the linear correlation showed the presence of a statistically significant correlation relationship between the application of total quality management and continuous improvement of performance. The results of the linear correlation showed the presence of a statistically significant correlation between total quality management on achieving economic and environmental returns, as it found a significant direct effect between total quality management and achieving economic and environmental returns. The study recommended evaluating patients' experience with hospital health services in terms of quality and efficiency. The effectiveness of the control methods applied by the facility to protect against any negative effects related to the activities, and the comprehensive quality management's formation and activation of committees specialized in quality in proportion to the size of the hospital, and I also achieved the design of questionnaires on a regular basis in hospitals to encourage customers (patients) to present their ideas and opinions from time to time,  The necessity of periodic review to ensure that hospitals are using resources effectively to achieve economic returns and preserve the environment.