Background: Successful insulin pump therapy is influenced by patient's adherence to self-care behaviors. Local data about the practices of patients using insulin pump are limited. The objective was to examine insulin pump related knowledge and practices among patients with T1D. Methods: A survey study was conducted among adult patients with T1D receiving care at a specialized center in Saudi Arabia. Data were collected between January and March 2021 using 56-item questionnaire covering 10 domains of insulin pump practices. Results: A total 71 patients were included. The average age was 27.6±7.9 years and 74.6% of the patients were females. The average duration of diabetes was 12.8±6.8 years. The overall score of knowledge and practices was 69.4%. The domain with highest score was pump operations (81.3%), followed by pump failure and issues (73.2%), recording and follow up (72.8%), temporary pump removal (71.5%), use of advanced pump features (70.6%), travel and going out (69.9%), management of acute complications (69.7%), pump maintenance (64.1%), exercises and stressful conditions (63.0%), and lastly infusion site infection (24.7%). There were no associations between the level of knowledge and practices and the patient's age and gender. Approximately half (50.7%) of the patients expressed their need for counselling to improve their skills in using insulin pump. Conclusions: The current findings point to the domains that need further education and training, specially guarding against infusion site infection and exercise-induced hypoglycemia. The findings justify conducting a larger pre and post study to examine the impact of customized reeducation intervention.