Background Sharkia governorate is one of the densely populated governorates with different health needs. They are suffering from both noncommunicable and communicable diseases and rising issues of reproductive health problems. The health needs assessment project aims to assess the most prevalent health problems and priority health needs of Sharkia Governorate inhabitants. Methods A pilot study of the health needs assessment project was carried out. A survey of 144 inhabitants was conducted during the medical campaign of Zagazig -Faculty of Medicine at Markaz Awlad Saqr, and also from Zagazig city. The Data Collection team included eight Public Health & Community Medicine Department members and eight Family Medicine Department members. Questionnaires were completed, and anthropometric and laboratory examinations were done. Questionnaires (household and individual questionnaires) were included to investigate common causes of morbidity and mortality in each age group and their satisfaction with provided health services. Results Half of the participants were of moderate social class. Gastrointestinal (GIT), respiratory & circulatory health problems were the most frequent health problems among the studied participants in present history (40.3%, 34%, and 30.6%, respectively). Two-thirds of the participants didn’t practice sports, and 13.2% were smokers. One-third of the participants have difficulty accessing health services mainly because of the high cost. Conclusion The pilot study of the Health Needs Assessment project in Sharkia Governorate revealed that many inhabitants suffered from chronic conditions