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Purpose: To examine the association of self-esteem with the body mass index (BMI), perceived body image (BI), and desired BI of college-age Saudi females., Methods: A cross-sectional study was conducted with 907 randomly selected females using a multistage stratified cluster sampling technique. Self-esteem and BI were assessed using the Rosenberg Self-Esteem Scale and Stunkard Figure Rating Scale, respectively., Results: The prevalence of low self-esteem was only 6.1% among college females; however, this percentage was higher (9.8%) among overweight or obese participants. The total self-esteem scores showed significant negative correlations with actual BMI and perceived BI, but not with desired BI. Meanwhile, multivariate analyses revealed significant differences in total self-esteem scores according to obesity/overweight status and perceived BI group, but not desired BI group., Conclusion: Despite the high prevalence of overweight and obesity in Saudi Arabia, few Saudi college females have low self-esteem. In addition, body weight, BMI, perceived BI, and the BMI corresponding to the perceived BI all significantly differed between females with low self-esteem and those with normal self-esteem., Level of Evidence: Level V, cross-sectional descriptive study.