Objectives Physiotherapy has evolved over the years in training and practice. Physiotherapists’ perception of first contact physiotherapy (FCP) and the patient self-referral (PSR) practice model in Nigeria may form a basis for the actualization of FCP practice in Nigeria. This study assessed physiotherapists’ perception of FCP practice and PSR in Nigeria. Design and setting This study was a cross-sectional survey of 72 physiotherapists from purposively selected academic and health institutions. Methods A previously validated questionnaire on the global view of FCP and PSR was used in this study. Data were analyzed descriptively. Results The majority of the physiotherapists were aware of national legislation regulating physiotherapy practice (97.2%) and defined the scope of practice (94%) in Nigeria. Respondents who expressed the view that the expected competency of entry-level physiotherapy is sufficient for first contact practitioners were in preponderance (75%). More than half (52.8%) of the respondents perceived medical and political views, as well as professional skills of the physiotherapists as strong barriers to first contact physiotherapy practice in Nigeria. Conclusion Physiotherapists in Nigeria seem to intuitively recognize some form of first contact practice or direct access to patients, but unfortunately lack the legislative backing for such practices. There is a widespread assumption of professional autonomy among physiotherapists in Nigeria.