The director of seven shorts and seven full-length feature films, Saleh graduated in 1949 in English literature and was trained in cinema in Paris until 1951. Tewfik Saleh's oeuvre is the only one in Egyptian cinema which may be considered purely "Third Worldist". All his films deal with social injustice, underdevelopment, political abuse and the class struggle.

His first film, Darb al-mahabil (1955), co-written by Najeeb Mahfouz, was set in a popular neighborhood but represented a kind of allegory of greed and materialism, dismantling the opportunism of the alley's inhabitants who chase a mentally retarded homeless person after they learn he has won the lottery. It took Saleh another seven years to direct his Sira' al-abtal (1962), set during the cholera epidemic of the 1930s. It featured Shukri Sarhan as a leftist country doctor who battles not only against the disease, but also against the peasant's ignorance, the midwife's intrigues and the egocentric interests of the feudal landowner.