The former president, looking pale and dressed in white, pleaded not guilty as he lay on a stretcher in a metal-barred cage to the premeditated murder of protesters who took to the streets to topple his regime in an uprising that erupted on January 25.
He and his sons Alaa and Gamal also denied all corruption charges.
After a four-hour hearing -- the former strongman's first public appearance since he resigned on February 11 -- the trial of the Mubaraks was adjourned until August 15.
Former interior minister Habib al-Adly and six of his deputies were also in the dock in the same case, and they are due in court again on Thursday.
Judge Ahmed Refaat, presiding over the Cairo Criminal Court, said Mubarak would be staying at the International Medical Centre, a hospital on the outskirts of Cairo, until the next hearing.
In response to a request by the defence team, Refaat agreed to allow an oncologist to follow up on Mubarak's health during his hospital stay.
Alaa and Gamal seemed composed throughout the hearing and appeared to take turns to shield their ailing father from the television cameras, leaning down regularly to talk to him.
The trial of Mubarak, whose spectacular downfall sent shockwaves across the region, was a key demand of the uprising.
Emotive public reaction
The Muslim Brotherhood, which was banned under Mubarak and formed the Freedom and Justice Party (FJP) after his ouster, hailed the trial as "a real victory for the will of the people."
"The fact that millions could watch the trial on television screens will reassure the Egyptian people that justice is on the right course," said FJP secretary general Saad Katatni.
"If things continue in this way, it will build the bridges of trust between the people and the ruling body in Egypt during this phase," Katatni said.
At the court, one civil society lawyer called for Field Marshal Hussein Tantawi, head of the ruling Supreme Council of the Armed Forces (SCAF) and Mubarak's long-time defence minister, to appear as a witness in the trial.
Lawyers jostled for microphones during the hearing that was for the most part conducted in an orderly manner.
"God gives sovereignty to whom he pleases, and takes away sovereignty from whom he pleases. God glorifies whom he wills, and he humiliates whom he wills," one of the victims' lawyers, quoting the Koran, Islam's holy book, recited to the judge.
Outside the courtroom clashes erupted between loyalists and foes of the former president, with several people injured.
Pro-Mubarak protesters carried pictures of him, while his opponents held up posters of the former president behind a noose, and security forces stepped in repeatedly to separate both sides.
The crowd, including families of victims killed during the uprising, had been watching the trial on a large screen outside the Police Academy -- once called the Mubarak Police Academy.
Until the last minute, it was widely believed Mubarak would not show up, or that the trial would open and then be adjourned indefinitely.
It was an epic downfall, unthinkable just six months ago, a once absolute ruler now a caged infirm.
The hearing has gripped the nation, and Cairo's usually bustling streets were abnormally quiet during the proceedings.
Mubarak, 83, was flown to Cairo from the Red Sea resort of Sharm el-Sheikh where he had been in custody in hospital being treated for a heart condition.
Security was tight, with barbed wire outside the Police Academy and more than a dozen riot police trucks securing the entrances, an AFP reporter said.
The trial is being held in an auditorium fitted with a large black cage to hold the defendants, including Adly on whom Mubarak relied to quell the revolt, and six police chiefs.
Businessman Hussein Salem, a close associate of the Mubaraks, is being tried in absentia.
The defendants are accused of stealing millions of dollars from the state and ordering the killing of anti-regime protesters during the uprising.
More than 1,000 police and soldiers secured the complex and vetted some 600 lawyers and journalists.
For weeks, it seemed likely that Mubarak, who doctors say refused to leave his hospital bed, would be tried in Sharm el-Sheikh, but the justice ministry announced last week the trial would be held in Cairo.
His lawyer Farid al-Deeb claimed that Mubarak suffers from cancer and went into a coma last month, which the hospital denied.
One of his doctors told AFP the ex-president was stable, but extremely depressed and weak after refusing food for several days.
Deeb's announcements appear to have been intended to increase sympathy for Mubarak and spare him the indignity of appearing in the defendants' cage.
But the military, which assumed power after Mubarak's resignation, is keen to prove it harbours no lingering loyalties to the former president.
The trial is the latest in a string of legal proceedings against Mubarak-era officials.
Several ministers have already been given jail terms in corruption cases, including Adly, already sentenced to 12 years for graft.
On Tuesday, international rights groups urged a "fair and transparent" trial.
"This trial presents a historic opportunity for Egypt to hold a former leader and his inner circle to account for crimes committed during their rule," said Malcolm Smart, Amnesty International's director for the Middle East and North Africa.
Sarah Leah Whitson, Middle East and North Africa director at Human Rights Watch, said: "If these proceedings scrupulously reflect the international fair trial standards, it will embody a clean break with the record of impunity that characterised Hosni Mubarak's rule, contribute to a new and hopeful chapter in Egypt's history, and set an important regional precedent."
COMMENTS (8)
Comments are moderated and generally will be posted if they are on-topic and not abusive.
For more information, please see our Comments FAQ
After Mubarak that steel cage should be preserved for Gen (Retd) Musharraf.
@Realist.: Is this not an English language forum?
Kindly for the sake of those who do not understand the language; please keep to language limited to English. Thanks a bunch!!
Too little too late. He has killed so many. He wasted so much of time and resources of Egypt. Even if he is hanged, the loss time cannot be brought back. However it could be an example for some Muslim leaders. Mr Mubaraik is suffering from Power loss syndrome. Days before he was removed, he was all fit and upright. His elixir was the power which kept him going. He should be sent to Israel to where he belongs. He should see on his death bed the love that he is going to get from his friend.
@Realist.: Why be biased??? U want to C the corrupt accountable then atleast WISH that it be across the board. As long as we keep picking and choosing the people we want to see punished... the corrupt and looters will keep finding friends amongst the ranks to bail them out. This present government is an elected on, our people wanted them and so did some when Nawaz came in to power. No one man has been the only lonely corrupt one in our country and to get them all.......well only God knows how long His arm is for the leaders of our nation. One thing the Arab Spring brings to mind is Iqbal's verse: "Khuda nay aaj tak us koum ki halat nahin badli Na hou jis kou khayal KHUD apni halat kay badalnay ka"
(God has never changed the lot of any nation who themselves don't have it in their heart to change it)
What they say in urdu "Yeh Waqt kis Ki Raoonat Pe Khaak Daal gaya Yeh Kaun bol raha tha kal Khuda k Lehjay mein"
I WISH To see Musharraf in a Trial court One day!! Insha'Allah I WILL!
I hope one day Pakistanis will be able to see their leaders in a cage!
Let this trial be a notice to all corrupt, sadistic rulers of the world that God has a long arm of justice & eventually it will be served to them.
The looters/rulers all can run but they cannot hide.