The film talks about a man called Yehia, who unwillingly comes out of isolation after five years, to resume his service in El-Abbaseya psychiatric hospital, where he is in charge of evaluating the mental health of the criminally insane.

Director Marwan Hamed proposed a change in the closing scene of the movie to allow the film to adapt and satisfy a large mass of audience.

But then he receives a warning from work and returns to his duties in El-Abbaseya psychiatric hospital where he is assigned 8 Gharb, a special department for mental patients who are also criminals.

Yehia's return coincides with the arrival of a former old psychiatrist friend, Sherif Al Kordy (Khaled El Sawy), a patient accused of brutally killing his wife.

[4] While he tries to unravel the many mysteries surrounding his friend, Dr. Yehia gets sucked into a sea of hallucinations, magic spells, numbers and demons, swirling around a tattoo parlor and a blue pill that bears the print of a six-legged elephant.

A month later on Eid al-Fitr 14 August 2014 the movie was available for viewers in countries such as (United Arab Emirates, Kuwait and Bahrain) Critic Mahmoud Mahdy of FilmGamed rated it 8 out of 10 and wrote: "The Blue Elephant is a cinematic achievement that should've paved the way for more courage and further adventures by Egyptian filmmakers.