The Egyptian midfielder joined Spurs for £1.5 million in January 2006, with the promise of bringing a creative edge to the Tottenham midfield. What he actually brought was a lack of commitment to the cause and a disturbing end with an act that ensured he would not be taken to the crowd's heart.
Initially, Ghaly settled into the reserves well, with some good skills shown in the hectic midfield. He looked languid and could pick out a good pass, but the physical side seemed to upset him. When he made the first team, he looked strong enough running with the ball, something he did well, but he was easily dispossessed and a disinclination to chase back and tackle. This was strange, as he was played as a full back in times of injury and was not the most disciplined when it came to keeping his shape. Was one of those players who was good on the ball but not off it.
When he had a good game, he looked very good. His display against Chelsea away in the Sixth Round of the FA Cup in 2007 showed exactly what he was capable of, taking the ball off a Chelsea defender and running at the defence before knocking it past the keeper. However, the instances of his ability were too far and few between. The crunch came in the home game in May 2007 against Blackburn Rovers, when he had taken to the field to replace Steed Malbranque on the half hour, but had such a poor game that the crowd began to give him stick. Misplaced passes and a reluctance to chase back after the ball to regain possession, he was taken off to be replaced by Robbie Keane. This brought about a petulant reaction from the midfielder, who stormed off the pitch past Jol, throwing his short to the ground arousing the great displeasure of the Spurs faithful.
His name was often linked with a move away from the club, with Ghaly claiming that a number of top European clubs were interested in him, but following a long pursuit by Birmingham City, he moved to St. Andrews in July 2007 for a fee of £3 million. Except he didn't. A few days later, it was announced that the Blues had pulled out of the deal for "footballing reasons", leaving Ghaly to return to Tottenham. It was rumoured that he had a training ground strop in a practice match and Steve Bruce identified that he had a "bad attitude" meaning he could go back to Spurs.
After that, his career at Tottenham was effectively finished. He disappeared from the Lane and was said to be training with former club Al-Ahly in Egypt to get fit for the Egyptian challenge for the African Cup of Nations, but he returned to England, missing the tournament, after a loan to Derby County was arranged in January 2008.
At the end of that season, he returned to Tottenham, but was not given a squad number by Head Coach Juande Ramos, thus indicating that he could leave the club as he would not play a part in his future thinking. Once Ramos was sacked in October 2009, his replacement Harry Redknapp brought Ghaly back into the squad and praised him for working hard in training. Unfortunately, his appearance taking his tracksuit off to come on as a substitute in the FA Cup Third Round tie against Wigan Athletic brought boos from the Tottenham crowd and the player sat back down, as Redknapp did not want to disrupt the flow of Tottenham's game.
The manager and several players came out in support of Ghaly, who they said had made a mistake in throwing his shirt, stating that the Spurs fans should give him a second chance. However, there appeared to be no way back for him, as he failed to make the bench for the League Cup semi-final second leg, when Spurs had a weakened squad and also for the FA Cup Fourth Round tie at Manchester United.
Shortly afterwards, on January 26th, the club confirmed that Hossam Ghaly had left to join Saudi Arabia club Al Nassr for an undisclosed fee, but just after just 19 months, he moved back to his first club, Al-Ahly, where he was a junior and he was given the number 14 shirt and the captain's armband. Enjoyed success as captain in November 2012, when he lifted the African Champions league trophy following a 3-2 aggregate win for his club over Tunisian side Esperance.