Aim: In this study, we aimed to determine the prevalence and main causes of visual impairment (VI) among Saudi children of Arar, the capital city of the Northern Border Region of Saudi Arabia. Material and Method: This population-based cross-sectional study was conducted on 410 Saudi children aged from 6 to 16 years. The examination included visual acuity (VA) testing, ocular motility evaluation, refraction, slit lamp, and fundus examinations. Results: A total of 410 Saudi children aged from 6 to 16 (9.8 ± 2.9 years) were enrolled in the current study; 195 (47.5%) were males and 215 (52.4%) were females. According to WHO classification, VI was diagnosed in 42 (10.2%) cases and 36 (8.7%) cases suffered unilateral diminution of visual acuity (UDoVA). Cases of VI were further classified depending on the severity of VI into mild VI in 34 (8.3%), low vision in 6 (1.4%) and blindness in 2 (0.04%) children. Visual impairment was more common in children aged ≤ 10 years. Refractive error was the most common eye morbidity diagnosed in 167 (40.7%) children of the studied population followed by strabismus in 28 cases (6.8%), then amblyopia in 10 cases (2.4%). Discussion: Visual impairment (VI) in children can have a significant impact on the quality of their life including their performance at school and future employment opportunities. Visual impairment among Saudi children in Arar city is highly prevalent. The leading causes are refractive errors, strabismus and amblyopia. Strategies focused on screening, timely diagnosis and treatment of these causes should help to reduce the burden of childhood VI.