BackgroundIn early 2021, vaccination against COVID-19 became one of the most important measures needed to control the pandemic. ObjectivesThis study aimed to investigate the levels of acceptance and factors affecting the decisions among Saudi parents and caregivers of children under 12 for getting them vaccinated. Design and settingA cross-sectional survey of 1000 caregivers and parents was carried out from May 2021 to June 2021. The participants were from the eastern, central, southern, western, and northern provinces of Saudi Arabia. Materials and methodsThe data were collected and managed using Microsoft Excel (Microsoft ® Corp., Redmond, WA) and analyzed using SPSS version 23 (IBM Corp., Armonk, NY). ResultsOf the 1000 respondents, 281 (28.1%) reported they would vaccinate their children, 346 (34.6%) rejected vaccination, and 373 (37.3%) were not sure. Most caregivers (24.1%; n = 241) reported protecting children as the principal reason for accepting vaccination. Regarding those rejecting the vaccine, the most common concern was that children might experience side effects (42.9%; n = 429). LimitationsThe acceptance of the COVID-19 vaccine is dynamic and changes with legislations and public awareness policies. ConclusionsCOVID-19 vaccine acceptance for children was low at the time of this study compared to the United Kingdom and United States. To achieve vaccination coverage that is adequate for herd immunity in Saudi Arabia, intense educational and awareness strategies are needed.