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Background: The use of lecture handouts is very common in all institutes of higher education, whether medical or otherwise. Students prefer handouts and think of them positively. On the other hand, teachers across disciplines have varied opinions regarding the utility and effects of handouts on learning outcomes. In our university, the use of lecture handouts is a common practice despite being officially discouraged. Materials and Methods: This cross-sectional, questionnaire-based study was conducted at King Khalid University, Abha, Kingdom of Saudi Arabia from March 2022 to August 2022 to assess the attitude and practice of Medical Colleges students' regarding handout use and their perception of the effects of handouts on the quality of undergraduate medical education. Given our set inclusion/exclusion criteria, out of 521 eligible student participants, a total of 430 students were enrolled in the study. Results: A 73.7% of respondents agreed that handouts helped them write notes and follow explanations in a better way, whereas 25.1% respondents reported that they were not willing to attend the classes when receiving handouts early. Majority of respondents (80.5%) thought that the use of handouts would improve their examination performance and GPA, while 31.6% think providing handouts might result in poor attendance. The most negative perception among the respondents was that 67.9% of the respondents believed that consulting references were only needed if no handouts are provided. Conclusions: We found that most of the students thought positively about the use of handouts. However, the results brought up many hidden but glaring negative effects of the handouts on attendance and reading from textbooks, which need to be addressed. [ABSTRACT FROM AUTHOR]