Introduction: Competencies are the correct combination of information; skills and behaviors owned by individuals and may be an exporter of continuous competitive feature for the organization. Estimating managerial abilities is significant for continuous improvement of health care quality. Aim of the work: To evaluate the competencies of Primary Health Care (PHC) facilities physician managers in Zagazig Health District, ElSharkia Governorate, Egypt and to rate the importance of the key management skills in their present situation. Material and methods: A cross sectional study was performed at Primary Health Care Facilities at Zagazig Health District, El-Sharkia Governorate, Egypt. The total number of managers was 46; all of them were included in the study as a comprehensive sample. The data were collected by modified self-regulated questionnaire for self-assessment of the doctors’ managerial competency. Data were used to rank the importance of different inquiries. Result: Most of the studied sample (52.2%) had low managerial competency particularly in staff management, planning and priority setting, problem solving and financial management but had high communication skills. As regards the importance of the managerial domains, least important domains were planning and priority setting, financial management and leadership while communication and problem solving are the most important crucial aspects. Managerial experience and qualification showed a statistically significant difference with all items of self-assessment managerial competency questionnaires of primary health care managers. Conclusion: There is a substantial gap in the competency level of primary health care sector managers. Management capability needs to be strengthened to promote the strategy of enhanced and sustainable delivery of healthcare service. To tackle the skill gap there is a need for suitable and further training and development