Background: Surgery has become an integral part of global health care. Surgical complications are common and often preventable. Although surgical and anesthetic caregivers seek to deliver optimal quality in peri-operative service, surgery still carries considerable risk for the patient. Aim of the study: This study aimed to assess a surgical safety performance among surgical teams and barriers in the operating room and its effect on the patient's outcomes. Study design: Descriptive exploratory research design was utilized to achieve the aim of this study. Research setting: The study was conducted in all operating rooms of both general and special surgical departments at Benha University Hospital, Qalyubia Governorate, Egypt. Study subjects: A convenience sample of available surgical teams of physician (200), of   nurses (200) in the operating room and patients (200). Tools of data collection: Four tools were used to collect data: Tool (I) A Structured Interview Questionnaire included two parts: Demographic data and Facilities and Resources Assessment, Tool (II) Observational Surgical Safety Checklist practice assessment, Tool (III) Intrusive Barrier of a Surgical Safety Checklist Assessment and Tool (IV) Patients' health outcome assessment. Results: The nurse, anesthetists and surgeons were compliance with all phases of World Health Organization (WHO) surgical safety checklist performance with mean score 88.5%, 88.9% and 87.9% of total score respectively, and 46.5 % of the studied patients had no postoperative problems, while 9.5 % had life threatening problems. Conclusion: There was highly significant negative correlation between the total nurses, surgeon and anesthetists' practice compliance with WHO surgical safety checklist and postoperative patients' outcomes and there was a positive and insignificant correlation between patients' outcomes and the barriers. Recommendations: Providing training programs to health care workers to enhance compliance of surgical safety checklist level and patient safety.