Aim of Study: To identify difficulties and barriers facing primary health care physicians in rural areas of Aseer Region, Saudi Arabia. Methods: This cross-sectional study was conducted at primary healthcare centers (PHCCs) belonging to the Saudi Ministry of Health, in rural areas of Aseer Region. A total of 134 physicians participated in the study. A validated study questionnaire was adapted and used for data collection. Results: Female physicians constituted 43.3% of respondents, age of 58.2% was 30-35 years, (Mean±SD: 32.8 ± 7.0 years), 54.5% were married, the salary of 76.1% was <10,000 SR, and the place of residence of 43.3% was in urban areas. Only 34.3% had opportunities for on-the-job continuing medical education, 33.6% were satisfied with medical equipment and resources, and 50% were dissatisfied with their salary. Internet service was present for 83.6% of participants. The social life of 83.6% was negatively affected, and 16.4% were exposed to violence at the workplace. Most participants had a favorable attitude toward working in rural areas, mainly in the form of professional satisfaction, pursuing postgraduate academic studies, building confidence as a clinician and provision of opportunities to upgrade knowledge and skills. Participants were less satisfied regarding several social factors, such as internet connectivity, isolation from family and relatives; received support from rural people, difficult schooling for children, but were not satisfied regarding PHCC infrastructure, their residential facilities, or earning more money. Conclusion: Serving within the rural healthcare system provides young physicians with an opportunity to build up their experience and to increase their confidence as physicians. However, important difficulties that they face are mainly social and financial. Hence, creating a health policy to safeguard the serving physicians’ career and providing facilities to promote personal and social well-being needs to be considered. Key words: Primary healthcare, rural health, difficulties, barriers, Saudi Arabia