Infrastructure is a fundamental pillar in the economic, social and political architecture of any modern state. It is a catalyst for economic growth, an instrument for maintaining social cohesion and a policy outcome that guarantees political stability. However, the effects of infrastructure development on the prosperity of nations are not uniform. This chapter tries to explain why Egypt still lags behind, with respect to a large number of international indices, despite the belief of all its leaders in the importance of infrastructure development, and despite the enormous amounts of funds directed towards this goal. It points to three possible explanations. First, a poor institutional environment which resulted, and is still resulting, in an inefficient process of prioritizing infrastructure projects, allocating resources and designing, implementing and evaluating chosen projects. Second, the existence of pervasive spatial inequality between Egypt’s largest urban governorates and its frontier and rural ones with regards to provision of both physical and social infrastructure, and which is confirmed by a geospatial primary analysis conducted by the authors. Third, the disproportionate investments in infrastructure, with a clear emphasis on physical at the expense of social infrastructure. The second and third themes are however rooted in the first, and fundamental, issue of institutional design and dynamics of political economy in Egypt. The chapter concludes with the urgent need for institutional reform that seeks to provide infrastructure efficiently and equitably to meet Egypt’s development promise.