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Multiple choice questions are considered to be the most objective, and valid tool for student assessment (Paxton 2000). Reasons of popularity of MCQs among medical teachers include their ability to test factual recall, interpretation of sets of data and problem solving. Also MCQs test a wide area of knowledge in short period of time and are of easy and objective scoring. Appropriately constructed MCQs result in objective testing that can measure knowledge, comprehension, application, and analysis. We aim to to identify the factors influencing students' performance in MCQs examination, by selecting final year medical students in pediatrics, obstetrics, surgery and medicine in school of medicine Ahfad University for Women 2012 - 2014.