Background: Preconception care (PCC) aims to address health risks before conception for better pregnancy outcomes. Effective PCC starts before pregnancy and involves interventions to improve well-being and prevent adverse outcomes. Unintended pregnancies and pre-existing illnesses increase risks. Early provision of care is crucial, as fetal development can be affected early. Improving women's knowledge and access to PCC is essential for optimal maternal and child health in Saudi Arabia., Methodology: A descriptive, cross-sectional study was conducted in Saudi Arabia to assess knowledge, attitudes, and practices regarding preconception care among women between the ages of 18 and 45 who live in Saudi Arabia, who matched the inclusion criteria. All women working in or studying in the medical field were excluded from the research. Data was collected using Google Forms (Google, Mountain View, CA) via social media apps. Data was cleaned in Microsoft Excel (Microsoft Corporation, Redmond, WA) and analyzed using IBM SPSS, version 29 (IBM Corp., Armonk, NY)., Results: Our study assessed awareness about PCC among 788 women. Age distribution revealed 24.9% (n=196) were 30-35 years old and 23.6% (n=186) were 40-45 years. Most were Saudi nationals (86.9%, n=685) and married (94.4%, n=744). University education was reported by 83.0% (n=654). Among notable findings, 79.1% disagreed or were neutral on PCC's necessity, and 78.6% supported free PCC. Barriers included fear of blood draws (68.7%) and negative family reactions (63.8%). Notably, 44.2% (n=348) demonstrated high knowledge and positive attitude towards PCC. Multivariate analysis indicated that marital status was significantly associated with high PCC knowledge (Exp(B)=1.956, p=0.049), while other sociodemographic factors were not associated with PCC knowledge., Conclusion: Our study showed an adequate level of knowledge about PCC among women. However, there is a need for further improvement in PCC awareness among Saudi women. A significant number of women supported free PCC services. Barriers included fear of procedures and family reactions. Marital status was significantly associated with higher PCC knowledge, emphasizing targeted educational interventions., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. National Committee of Bioethics/Umm Al-Qura University IRB issued approval HAPO-02-K-012. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Edris et al.)