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She eventually became the Director of the Ministry of Public Health and met her third husband, Sherif Hatata, while sharing an office in the Ministry of Health. After attempting to protect one of her patients from domestic violence, Saadawi was summoned back to Cairo. While working as a doctor in her birthplace of Kafr Tahla, she observed the hardships and inequalities faced by rural women. Her second husband was a colleague, Rashad Bey. Through her medical practice, she observed women's physical and psychological problems and connected them with oppressive cultural practices, patriarchal oppression, class oppression and imperialist oppression. That year, she married Ahmed Helmi, whom she met as a fellow student in medical school. Saadawi graduated as a medical doctor in 1955 from Cairo University. She described herself proudly as a dark-skinned Egyptian woman since she was young. Even as a child she objected to the male-dominated society she lived in, with sons valued far more highly than daughters, reacting angrily to her grandmother who said that "a boy is worth 15 girls at least. Her mother, Zaynab, was from a wealthy Ottoman descendant family Saadawi described both her maternal grandfather, Shoukry, and her maternal grandmother as having been of Turkish origin. Both her parents died at a young age, leaving Saadawi with the sole burden of providing for a large family. However, when El Saadawi was 10, her family tried to make her marry, but her mother supported her in resisting. He also encouraged her to study the Arabic language. He was relatively progressive and taught his daughter self-respect and to speak her mind. As a result, he was exiled to a small town in the Nile Delta, and the government refrained from promoting him for 10 years. Her Upper Egyptian father was a government official in the Ministry of Education, who had campaigned against the British occupation of Egypt during the Egyptian Revolution of 1919.

Saadawi was " circumcised" (her clitoris cut off) at the age of six, yet her father insisted that all his children be educated. The second-eldest of nine children, Saadawi was born in 1931 in the small village of Kafr Tahla, Egypt.