Background: Assessing elderly expectations and satisfaction with care can help developing better PHC community services to them Aim of the study: to identify the relationship between patients' expectations and their satisfaction with service quality in outpatient clinics. Methods: cross-sectional analytic study was conducted in the outpatient departments of the Health Insurance Hospitals in Beni-Suef and Al-Fayoum Governorates as a day-care services for old age on a consecutive non-probability sample of 195 elderly attending the settings. Data were collected using an interview questionnaire including the modified SERVQUAL tool to assess elderly expectations of and satisfaction with the day care services.The work was done from February to July 2020. Results: Elderly patients' age was mostly <65 years (83.1%), with 56.4% females. In total, 55.9% of them had total high expectations, but only 28.2% had high total satisfaction with care. Overall, 41.0% of them had their satisfaction exceeding their expectations. Their satisfaction and expectations scores were significantly and positively correlated (r=0.714). In multivariate analysis, urban far residence and being married were positive predictors of the expectation score, while the duration of illness was a negative predictor. Satisfaction score being married and living in urban far residence were positive predictors, whereas duration of illness was a negative predictor. Conclusion aged patients have low expectations of the day-care services provided, their satisfaction with the care is even lower and these scores are positively correlated. A corrective actions particularly regarding service reliability and responsiveness. Training courses in gerontology are required for all categories of healthcare providers