This paper addresses the political struggles and institutional changes that have occurred in Egypt’s health care sector in the context of the country’s political upheavals since 2011. I discuss changes that have been taking place at both the local and the national levels. At the national level the takeover of the Muslim Brotherhood hospitals after the removal of Muhammad Morsi from power has received the most attention by outside observers. While I discuss this development and its significance, I argue that this focus has obscured other important developments in the politics of health care and health care reform, which have developed along particular trajectory shaped by the events and aftermath of the 2011 revolution. These include the controversial new health insurance reform initiative, and political struggles between the doctors and the national security apparatus. On the local level this paper will discuss political struggles and institutional change at the level of the hospital. Previous discussion of the activist roles of doctors has been largely limited to their role during the mass popular mobilizations of 2011 and after. However, I will discuss cases in which the revolutionary moment provided opportunities for activist medics to challenge the old guard inside public hospitals to make sweeping reforms or even what they view as revolutionary changes in the organization of the facility. Some of these changes have been surprisingly persistent even following the restoration of a military-backed political system in 2013. The paper concludes by weighing up the continuities and changes in relation to the pre-2011 health sector, and the prospects for further health care reform in contemporary Egypt. I consider how institutional change and continuity in the health care sector can help us theorize continuity and change in other areas of post-Mubarak Egyptian politics and society. Evidence is drawn from sources gathered over one year of field research, including numerous in-depth interviews with doctors, patients, policy experts and officials, observations inside clinical facilities, and print and media archives in Arabic and English.