Uruguay Friday won their first World Cup group-stage game since 1970, as Jose Gimenez scored the all-important goal.
Luis Suarez was denied an attempt early in the second half by Elshenawy, who made a save with his body.
Egypt was dealt with a blow when Tarek Hamed had to come off due to an injury.
Full-back Ahmed Fathi hit a powerful shot at goal, forcing Muslera into his first real save of the game.
Elshenawy denied Cavani a goal in the final ten minutes with a superb save, as Cavani tested him with a powerful shot. His terrific free-kick hit the post, while Sanchez blocked Caceres' rebound in a frantic ending to the game.
Jose Gimenez scored late on as he rose above the Egyptian defence to head the ball past Elshenawy.
There was no appearance from Liverpool's Mohamed Salah.