The screening of newborn children for metabolic and endocrinological disorders is one of the unsung successes of the health service. This study aimed to evaluate the congenital hypothyroidism (CH) screening program in Alexandria in terms of coverage, effectiveness of detecting and managing the cases. A record review was conducted at the Information and Decision Making Support Center of Alexandria Health Directorate during the period from October 2000 to December 2003 to evaluate the coverage of the program and to detect the number of true positives and false positives used to calculate the positive predictive value of the screening test. A follow- up study was conducted at the pediatric clinic of the Student's Sporting Hospital for all positive cases detected by the (CH) screening program attending the clinic for diagnosis, confirmation and treatment during the year 2002 (30 cases were followed-up) . The percentage of program coverage was 49.4%, 63.3% and 77.6% in the years 2001, 2002 and 2003 respectively. The total positive cases in the three years were 26, 30, and 14 with positive predictive value of 65%, 57%, and 64% respectively. About three-quarters (73.3%) of all positive cases (30 cases) were compliant to therapy. Compliance was on fixed times in more than half of cases (56.7%), and irregular in 40%. There was a positive trend of increase in program coverage and effectiveness in detecting and managing the cases through the three years of the study.