Background: Substance use disorders can cause serious harm and manifest as psychological, physical, or legal issues. Drug abuse may be used as an alternative strategy since people struggle to manage their emotion regulation problem. Hence, it is hindering their ability to change as a consequence. Aim: to assess the role of alexithymia and self-concealment in predicting readiness to change among patients with substance use disorders. Subjects and method: Design: A descriptive correlational design was utilized in this study. Setting: The study was conducted at neurology, psychiatry and neurosurgery center, Tanta university. Subjects: A purposive sample of 107 patients with substance use disorder was chosen to be subjects for this study. Tools: Sociodemographic and clinical data questionnaire, Toronto Alexithymia Scale (TAS-20), Self-Concealment Scale and Readiness to Change Questionnaire [Treatment Version]: RCQ[TV]. Results: 74.8 % of study subjects had high and moderate degree of alexithymia. Also, 78.5% of them had a high and moderate degree of self-concealment. Regarding readiness to change, 52.3% of the study subjects have merely mild degree of readiness to change. Alexithymia acts as a predictor of readiness to change among patients with substance use disorders. Conclusion: Patients with substance use disorders are often less aware of their emotions and hide their negative experiences from others. Subsequently, this is affecting their willingness to modify the current state of abuse. Recommendation: Improving realization of emotions and emotional management is an important part of the treatment of patients with substance use disorders.