However, he was issued a special invitation to this year's competition which saw a number of other bodybuilders withdraw, including names such as Cedric McMillan, Flex Lewis and James Hollingshead.
Just a week before the event, Roelly Winklaar also had to pull out because he tested positive for Covid-19.
With this Olympia win, Elssbiay becomes just the 16th male bodybuilder and the second from the Arab world to win the Mr Olympia title since the contest started in 1965.
Samir Bannout, known as the "Lion of Lebanon" won in 1983.
The Mr Olympia top five for 2020:
Winner – Mamdouh Elssbiay, $400,000
Second place – Brandon Curry, $150,000