Background: Intrauterine device (IUD) is one of the widely adopted contraceptive methods all over the world, especially in developing countries such as Egypt. The study aimed to assess the psychological effects and pain in Egyptian females on their first use of IUD. Subjects and Methods: Multicenter longitudinal cross-sectional study, started from June 2018 till July 2022, in the tertiary hospitals in 7 Egyptian governorates. About 553 participants were subjected to a pre-designed validated questionnaire including data on pain and psychological effect of IUD insertion with its different forms. Results: Psychological effects of IUD were felt more at insertion but later on they changed greatly from marked to not being detected, however, there was a slight increase in pain and discomfort later on after insertion (P<0.001). The absence of knowledge about IUD insertion was present in 44.3% of the participants. Knowing how IUD is inserted was associated with the presences of these psychological effects(P=0.014 and <0.001 respectively). There was an association between male doctor gender and less psychological effects and pain (P<0.001). Conclusion: There were negative psychological effects and pain among Egyptian women during the insertion of IUDs. Also, there was a low level of awareness about the IUD in most of the females.