Al-Tilmisani headed the Muslim Brotherhood during a period of cooperation and, some observers suggest, cooptation by the Egyptian state.

While the Brothers were not precisely legal during Tilmisani's term, they were tolerated and encouraged by Egypt's former President Sadat as a bulwark against both leftist opponents and more Islamists.

[citation needed] His deputy, and a later successor as General Guide, Mustafa Mashhur, was also from a family of wealthy landowners.

Their prominence and social status led historian Robert Springborg to conclude at the end of the 1980s: "It can reasonably be claimed that those currently in control of the Muslim Brothers are of the Islamic infitah bourgeoisie who 'bought' the organization with resources acquired through collaboration with the Sadat regime".

[1] Salih Ashmawi, a senior Brotherhood member until his expulsion in 1953, asked al-Tilmisani to help him in reviving Al Dawa which had been published in the period 1951–1953 as an official organ of the group.