ABSTRACT: BACKGROUND:Physical inactivity is a major health issue in Saudi Arabia (SA). Being physically active can improve overall health and prevent the risk of noncommunicable diseases and their consequences. The objective of this study was to assess the knowledge, attitudes, and practices of primary health care physicians in SA toward physical activity (PA) and identify the correlates of PA counseling provided by physicians. METHODS:A cross-sectional study was conducted in four main cities of Eastern Province, SA (Al-Khobar, Dammam, Qatif, and Safwa). A total of 147 physicians (44%) filled out self-reported surveys that were used in the assessment of the aims. RESULTS:Overall, 59.9% of the physicians believed that PA promotion to patients was their responsibility, and 53.7% of the physicians felt confident in their ability to provide PA counseling. However, the physicians indicated that lack of time, inadequate referral services for PA, and inadequate training in PA counseling are barriers to providing PA counseling to their patients. Only 5.4% of the physicians had excellent knowledge about PA recommendations. Female physicians were more likely to promote PA than male physicians (OR, 3.72; 95% CI, 1.10-12.58; P = .03) and more likely to assess PA in pediatric patients (OR, 2.61; 95% CI, 1.03-6.61; P = .04). Compared to other specialties, family physicians were more likely to provide general PA counseling to patients without chronic diseases (OR, 8.86; 95% CI, 1.86-42.13; P = .006). Physicians who saw fewer adult patients were more likely to systematically track/follow-up on the PA of patients (OR, 3.13; 95% CI, 1.14-8.58; P = .03) and to promote PA to pediatric patients (OR, 2.87; 95% CI, 1.37-6.00; P = .005). CONCLUSIONS:Training medical staff in PA counseling and strengthening the health care workforce and infrastructure can help physicians improve their counseling practice.