Background: Nowadays, the ability to deliver excellent quality to customers is key to an organization's survival and global competitiveness. Essentially, delivering excellent quality increases customer satisfaction and enhances the productivity of institutions. The implementation of quality improvement initiatives, such as Total Quality Management (TQM), is one way that organizations are seeking to deliver quality services to customers. Aim: the study aimed to assess factors affecting application of total quality management activities at Oncology Center Mansoura University. Method: A descriptive research design was utilized to conduct this study on 239 nursing staff working at Oncology Center Mansoura University using one tool as: total quality management activities Questionnaire. Results: The results indicated that more than tow third of nursing staff had moderate agreement score about factors affecting application of total quality management activities. Method used for quality indicators measurement was found the highest and ranked first. Whereas Financial and moral incentives was significantly the lowest and ranked last one. That there was highly statistically significant positive relationship between nurses 'perception for overall score related to factors affecting application of total quality management activities.Recommendation: Hospital manager sustain more flexible remuneration and reward systems to promote nursing staff satisfaction. Hospital manager should provide open channels of communication between top management and nursing staff and providing them with feedback on progress.