OBJECTIVE: The aim of this study is to explore the attitudes of the students of Health Sciences College in Abha, Kingdom of Saudi Arabia (KSA) towards premarital counseling. METHODS: This study was conducted among the students of Health Sciences Colleges in Abha, KSA, during the 2nd semester of the academic year of 1999-2000. A self-administered questionnaire was distributed to all available students who answered it under the direct supervision of the Heads of Departments. The questionnaire consisted of 3 main parts; the first part was regarding socio-demographic and scientific characteristics, the 2nd part concerned with attitudes towards premarital counseling while the 3rd part explored the preferred items to be included in premarital counseling. Data of the questionnaire were entered and analyzed by statistical package for social sciences. Association between categorical variables were tested by Chi-square test and considered significant if (P-value less than 0.05). RESULTS: One hundred and eighty-six students responded, giving a response rate of 70%. Seventy percent of students showed acceptance of premarital counseling while 13% rejected it. Legalization of premarital counseling was agreed on by 19% compared to 41% who refused it. Family history and blood tests for hemoglobinopathies were the most common 2 items preferred to be included in premarital counseling by the respondents. CONCLUSION: This study showed that most of the students at Health Sciences College in Abha, KSA have good attitudes towards premarital counseling in spite of a few students who justify their refusal by the misunderstanding of Islamic rules. This misunderstanding needs intensification of health education in which religious leaders are involved to clarify and correct this misconception.