Introduction: This study assessed the primary healthcare physicians’ knowledge and practices toward the red flags of low back pain (LBP) and factors associated with awareness. Methodology: This cross-sectional study was conducted between October 2020 and June 2021 in primary healthcare (PHC) settings in Jazan, Kingdom of Saudi Arabia. Questionnaires were electronically distributed among 261 primary physicians with a 96.1% response rate. Result: Of the 261 physicians included, 56% were male, 49.4% were aged between 35 and 44 years, and 76.9% were non-Saudi. Moreover, 49% of the physicians had one to nine years of experience and 33.1% indicated that they deal with >30 patients with back pain per month. Furthermore, it was found that 86.9% of the participants were aware of the overall red flags of LBP. Job category and the number of cases were significant factors of perceived awareness. The highest level of self-reported awareness was among consultants. The rate of referral patients with nonspecific back pain was highest among general practitioners. More than 95% of the participants would refer patients to hospital if they noticed the presence of red flags for LBP. Conclusion: Awareness of physicians practicing in PHCs through the red flags of LBP in Jazan is good, and recognition of the need for the referral of a patient with suspected critical illness is good as well.

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