Patients with substance use disorder (SUD) often experience high levels of guilt. These feelings of guilt can lead to a generalization of negative emotions towards their substance use, impacting their motivation for treatment. Aim of the study: Assess treatment motivation and guilt feeling among patients with substance use disorder. Subjects and Methods: Research design: A descriptive correlational design was adopted to carry out this study. Setting: The present study was conducted at El-Azazi hospital for mental health in Abo Hamad City, Alsharkia Governorate, Egypt. Sample: A purposive sample of patients with substance use disorders (n= 153). Tools of data collection: Three tools were used for collecting data. Interview questionnaire sheet which composed of Socio-demographic and clinical data sheet, The Circumstances, Motivation, and Readiness (CMR) Scale. and Test of Self-Conscious Affect-3 (TOSCA-3). Results: The total mean score of treatment motivation was 76.22±7.45 and mean score of guilt feeling was 44.22±6.61. Conclusion: There was a highly statistically significant positive correlation between patients’ motivation for treatment and guilt. Recommendation: Designing and implementing psych-educational programs for addict patients to improve their motivation for treatment and employ motivational interviewing techniques to help patients explore their ambivalence about treatment and guide them towards making positive changes.