In 1980 Kotb joined the workforce.[7] In the 1990s she joined the Régie du bâtiment, the engineering safety watchdog of the Government of Quebec, where she eventually headed of the Pressure vessel Technical Services Division.[8]
From 1989 to 2015 Kotb also served on the Canadian National Board of Boilers and Pressure Vessels Inspectors,[9] and in the year 2013-2014 she served as 132nd president of the American Society of Mechanical Engineers.
^Madiha El Mehelmy Kotb, "Changes I found and changes I took in my life," in: Samia Spencer (ed.). Daughters of the Nile: Egyptian Women Changing Their World. 2016. p. 239.
^Nancy Salim, "Under Pressure: Engineering Is a Part of Life for Kotb [WIE from Around the World]." IEEE Women in Engineering Magazine 7.2 (2013): 45–46. (Abstract)