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Aim: To examine the patterns of systemic antibiotics prescription by periodontists in Saudi Arabia and to explore the rationale of their use. Materials and methods: An online, self-administered survey distributed to periodontists in Saudi Arabia questioned about antibiotics prescription practice in different periodontal and implant procedures and prescription rationale. Results and discussion: 123 surveys in total. 93% of the respondents performed all clinical procedures. A significantly lower percentage of them would prescribe AB when dealing with traditional periodontal procedures like crown lengthening, compared to bone grafting. Invasive procedures, like sinus grafting or complex implant treatment, evidenced significantly higher AB prescription practices. The most common rationale for the prescription was to prevent infection, followed by the use of non-autogenous materials. 90% agreed on the need to establish an antibiotics stewardship program. Conclusions: Discrepancy in antibiotics prescription patterns among periodontists was noticed, which highlights the importance of developing evidence-based program for perspiration. [ABSTRACT FROM AUTHOR]