During the General Elections of 1947, Youssef Salim Karam was re-elected for a second time for the North Lebanon Governorate seat along with his running partner Hamid Frangieh.

Karam was elected for the third time in a row in 1951, making a strong showing by winning, along with his running partners, 5 out of the 6 North Lebanon Governorate seats.

Karam lost again during the General elections of 1957 to the opposing list in Zgharta-Zawyieh (Hamid Frangieh and René Moawad) along with his running partner, Father Semaan Douaihy.

However, Karam ran for the elections for the sixth time in a row in 1960, and was re-elected for the seat of Zgharta-Zawyieh with his running partners Suleiman Frangieh,[8] who was back from Syria after he was granted amnesty following his involvement in the Miziara massacre, and René Moawad.

On 16 June 1957, some of Karam's men went to see him in his home in Tripoli, informing him that a requiem mass was being held in Miziara, a village located in the south of Zgharta, for the repose of the soul of Salim el Abed who has died in Nigeria.