Background: Total Quality Management represents a modern management philosophy, established due to the development in all aspects of life in today's world. Aim: To assess nursing staff awareness regarding challenges for applying Total Quality Management at Assuit University Hospital. Research design: A descriptive study convenience sample design with a sample contains all nurses working in General Surgical, Special Surgical, General Medical, and Special Medical departments at Assiut University Hospital with a total number of n= 219. Tools: Total Quality Management Challenges questionnaire is used. Results: Show that above one-third of them agree about all items of challenges for applying total quality management. Conclusion: No statistically significant differences between quality management challenges with personal and occupational characteristics of the studied nurses at Assuit University Hospital. Recommendations: Conduct an awareness sessions about total quality management between nurses at Assuit University Hospital; Conduct a total quality management training or program to all nurses at Assuit University Hospital, And the availability of quality assurance coordinator nurse in each department who works to implement quality policies in the departments and act as a link between the department and the Quality Committee.