Orogenic, lode gold mineralisation in the South Eastern Desert of Egypt is related to quartz veins spatially and temporally associated with conjugate NW- and NE-trending brittle–ductile shear zones. These structures are assumed to be linked to a regional transpression deformation which occurred late in the tectonic evolution of the area. In the Betam deposit, gold is confined to quartz(±carbonate) veins cutting through tectonised metagabbro and metasedimentary rocks in the vicinity of small granite intrusions. The ore bodies contain ubiquitous pyrite and arsenopyrite, in addition to minor disseminated chalcopyrite, pyrrhotite, galena, tetrahedrite and rare gold/electrum. New ore microscopy and electron microprobe studies indicate that most free-milling Au is intimately associated with the late-paragenetic galena–tetrahedrite–chalcopyrite assemblage. An early Fe–As sulphide assemblage, however, shows minor traces of refractory gold. New mineralogical and geochemical data are used to better constrain on possible element dispersions for exploration uses. This study indicates that parameters that most consistently define primary dispersion of gold in the mine area include pervasive silicification, sericite and carbonate alteration. The trace element data of gold lodes reflect a systematic dispersion of gold and certain base metals. Low-cost, extensive exploration programs may use elevated concentrations of Ag, Sb, Cu and Pb as tracers for Au ore zones in the Betam mine area and surroundings.