This article introduces the reader to mental health in the Middle East with an Egyptian perspective, from the Pharaonic era through the Islamic Renaissance, up until the current state. During Pharaonic times, mental illness was not known as such, as there was no separator between Soma and Psyche. In spite of the mystical culture, mental disorders were attributed and treated on a somatic basis. The first mental hospital in Europe was located in Spain, following the Arab invasion, and from then on it propagated to other European countries. The 14th century Kalawoon Hospital in Cairo had 4 departments, including medicine, surgery, ophthalmology, and mental disorders. Six centuries earlier, psychiatry in general hospitals was recognized in Europe. This article discusses the current state of the mental health services in Egypt and the transcultural studies of the prevalence and phenomenology of anxiety, schizophrenia, depression, suicide, conversion, and obsessive compulsive disorders. An outline of psychiatric disorders in children is discussed. The problem of drug abuse is also addressed, especially that in Egypt after 1983, where drugs like heroine replaced the common habit of hashish.