BACKGROUND: Vaccine hesitancy poses serious challenges for achieving coverage for population immunity. It is necessary to achieve high COVID-19 vaccination acceptance rates and medical students' coverage as future health care providers. The study aimed to explore the level of COVID-19Vaccine hesitancy and determine the factors and barriers that may affect vaccination decision-making. METHODS: A cross-sectional study was carried out among medical students in Tanta and Kafrelsheikh Universities, Egypt. Data collection was done via an online questionnaire during January 2021 from 2133 students. RESULTS: The majority of the participant students (90.5%) perceived the importance of the COVID-19Vaccine, 46% had vaccination hesitancy, and an equal percentage (6%) either definitely accepted or refused the Vaccine. Most of the students had concerns regarding the Vaccine's adverse effects (96.8%) and ineffectiveness (93.2%). The most confirmed barriers of COVID-19 vaccination were deficient data regarding the Vaccine's adverse effects (potential 74.17% and unknown 56.31%) and insufficient information regarding the Vaccine itself (72.76%). CONCLUSION: The government, health authority decision-makers, medical experts, and universities in Egypt need to work together and make efforts to reduce hesitancy and raise awareness about vaccinations, consequently improving the acceptance of COVID-19 vaccines.