Tramadol dependence is a public health problem in Egypt. We aimed to determine the sociodemographic and clinical characteristics of tramadol abuse among Egyptians, the frequency and degrees of insomnia among tramadol abusers, and the relationship between the associated insomnia with sociodemographic and clinical characteristics. Included in this study were 400 subjects (mean age, 30.72±9.61 y) who were tramadol dependent. The subjects were assessed using Structured Clinical Interviewing using DSM-IV (SCID-I), Severity of Dependence Scale (SDS), and Insomnia Severity Index. We found that the mean age at onset of tramadol intake was 21.57±6.71years, and the dose of tramadol/day was 1550.6±438.8 mg; the duration of tramadol dependence was 6.29±4.35 years, and score of SDS was 10.19±2.55. There were 4 main causes of tramadol abuse: premature ejaculation/erectile dysfunction, particularly in male individuals, novelty seeking, escape from troubles, and peer pressure. In total, 69% of subjects had insomnia with a mean score of Insomnia Severity Index of 16.3±3.7. In multiple regression analysis for subjects with insomnia, the variables that were found to be significantly associated with insomnia were as follows: age at onset, dose and duration of tramadol dependence, and SDS scores. To conclude, insomnia is common in subjects suffering from tramadol dependence and is associated with dose, duration, and severity of tramadol dependence.