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Background: Patient safety is a global concern among healthcare providers. However, the challenges to and the future of patient safety have not been explored in details at primary health care centers in recent literature in the Kingdom of Saudi Arabia. The World Health Organization (WHO) defines patient safety as "the prevention of errors and adverse effects to patients associated with health care" and "to do no harm to patients". The study aims to identify and analyze factors that influence patient safety culture in the primary health care setting. Methodology: A cross-sectional study was conducted on primary health care physicians working in 12 primary health care training centers, cluster one, ministry of health, Riyadh city, Kingdom of Saudi Arabia, over a period of two months from the beginning of January, 2021 to the end of February, 2021 using a survey inspired from Hospital Survey on Patient Safety Culture (HSOPS). The HSOPS was developed by the Agency for Healthcare Research and Quality (AHRQ) in 2004 and has been translated into around 20 different languages. The questionnaire was answered by all primary health care physicians who accepted to be included in this study. The data was analyzed by Statistical Package for the Social Sciences (SPSS) latest version program. Results: In this study, the response rate was 94.55% and we were able to collect 208 responses of our questionnaire among primary health care physicians with 75% of the physicians were Saudis. 53.4% of the responders were males. The overall average positive response rate for the patient safety culture dimensions was 76.13%. Moreover, we found that 48.1% of the participants rated the procedures to achieve patients' safety is very good while 32.2% of them reported excellent patients' safety. Moreover, we found that almost half of the physicians (46.2%) reported no event reports in the last 12 months while 28.8% reported 1 -2 events, 20.2% reported 3-5 events and only 1% reported 11-20 event in the last 12 months. Conclusion:The patient safety culture in primary health care facilities in Riyadh city, Kingdom of Saudi Arabia is good and gives better results than previous studies.

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