Fahmy runs her eponymous firm with her daughters, Fatma Ghali, who is CEO, and Amina Ghali, who is the head designer. Fahmy began her career in 1969, making jewelry pieces and selling them to her friends. Fahmy’s designs have been worn by celebrities, including Yousra, Julia Roberts, Joss Stone, Amy Adams, Rihanna, and Raya Abirached. In 2013, she independently funded and established the Design Studio by Azza Fahmy, a design training institute. In December 2022, she collaborated with French design house Balmain on a piece celebrating Ancient Egypt.