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Introduction: Over the past twenty years, dental practice in Saudi Arabia has developed considerably, along with increase in population’s knowledge of their rights. However, there is a lack of evidence and research on dental malpractice lawsuit cases in Saudi Arabia. The aim of this study was to assess the prevalence and content of legal suits regarding dental malpractice in Saudi Arabia, and to explore the factors and circumstances that were associated with these cases. Methods: This was a retrospective study on dental malpractice litigation cases between January 2017 and December 2020. Only cases with final court verdicts were included. The cases were collected from 13 Medico-Legal Committee (MLC) across Saudi Arabia while practitioners’ data were retrieved from the General Directorate of Healthcare Licensing at Ministry of Health (MOH). A designed data sheet was used, which was categorized into three main sections: plaintiff demographic data, defendant demographic, data case details in the court. Results: During the four years period, 864 cases with verdicts were studied. Most of the cases were against general dental practitioners, and majority of complaints involved prosthodontic procedures followed by endodontics. The majority of the malpractice lawsuit cases (93 %) were against non-Saudi dental practitioners and 72 % were against experienced practitioners with more than ten years of experience. Almost all cases were in the private sector. Only 10 % of cases had a consent form previously provided to the patients before treatment, and most of cases lacked proper medical documentation. The mean average trial period was 3.3 months and 76 % of defendants were found guilty. Conclusion: The number of cases is rising since 2017. Good documentation, compliance to informed consent protocols and dental privileges helped practitioners to avoid being found guilty.