Mahmoud Refaat led the presidential campaign of former Egyptian army chief of staff Lieutenant General Sami Anan from abroad and played a role in covering all the international media news of the arrest of General Sami Anan, which he explained in several televised meetings that he did so for fear of assassination of Lieutenant General Sami Anan. He then played a role again by questioning international circles in the presidential elections won by Egyptian President Abdel Fattah el-Sisi in the second round in March 2018, and sparked an international outcry two months later, accusing the Egyptian regime of El-Sisi of trying to assassinate General Sami Anan after the sudden health collapse, that hit him in his prison in summer 2018.