Background. in 2018, egypt underwent a health system reform programme, in which a universal health insurance system rolled out across the country beginning, with the Port-Said Governorate in July 2019. Objectives. this study was conducted to assess patient satisfaction and health system responsiveness among attendants to family health centres and units affiliated with universal health insurance in the Port Said Governorate, egypt. Material and methods. a descriptive cross-sectional study was conducted that included 156 patients who were seeking health care in family health centres and units affiliated with universal health insurance in the Port Said Governorate. a multi-clustering sampling technique was used. data was collected using an interviewer-administered questionnaire. Results. among the 156 patients who were enrolled in the current study, 54 were male (34.6%) and 102 were female (65.4%), with a mean age of 37.10 ± 15.22 years. regarding domains of health system responsiveness, about 73% of the attendants perceived the overall health system responsiveness as good regarding the domains of basic amenities, communication and confidentiality. on the other hand, three domains were perceived as poor, including autonomy, prompt attention and dignity (37.8%, 34% and 30.8%, respectively). Conclusions. it was found that more than two third of the attendants perceived the overall health system responsiveness as good.