Background and aim of work: Colorectal cancer (CRC) is a major cause of cancer mortality and morbidity worldwide yet it is considered a preventable disease. Screening asymptomatic persons by fecal occult blood test (FOBT) can reduce mortality from CRC. This prospective study was designed to assess the value of FOBT screening in the Egyptian population.Patients and methods: Patients were recruited as follows: Group 1 included 42 asymptomatic individuals who participated in a screening program of FOBT and colonoscopy while the other groups included 70 patients referred for colonoscopy. Patients were subjected to colonoscopy and findings were correlated with two different types of FOBT: Guaiac-based and immunochemical tests.Results: 31 cases of CRC and 22 cases with polyps were detected. 33 patients had normal colonoscopic findings. iFOBT was positive in 45 cases and negative in 55 cases with a sensitivity of 69% and a specificity of 86% while gFOBT was positive in 58 cases and negative in 42 cases with a sensitivity of 78% and a specificity of 82% for all lesions. gFOBT had a sensitivity of 93% for CRC and 45% for adenomatous polyps while iFOBT was 87% and 36% respectively. Conclusions: FOBT provides an acceptable screening method for CRC. iFOBT is a more specific test for screening than gFOBT but has a lower sensitivity in that respect.