Purpose Stigma associated with mental health problems is widespread in the Kingdom of Saudi Arabia (KSA). Consequently, this may prevent many Saudi people from accessing the mental health-care services and support they need. The purpose of this study is to consider how stigma affects people needing to access mental health services in the KSA. To achieve this aim, this study reviews the knowledge base concerning stigma and mental health in KSA and considers specific further research necessary to increase the knowledge and understanding in this important area. Design/methodology/approach This review examines the relevant literature concerning mental health stigma and related issues in KSA using the Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses frameworks. As a scoping review, it has used a systematic approach in literature searching. The results of the search were then thematically analysed and the themes were then discussed in light of the concepts of stigma and mental health. Findings Stigma around mental health impedes access to care, the nature of care and current clinical practice in the KSA. The voices of those with mental health issues in KSA are almost entirely unrepresented in the literature. Originality/value The review identifies that mental health stigma and cultural beliefs about mental health in KSA may act as barriers to accessing services. The voice of mental health service users in KSA remains largely unheard. If public discussion of mental health issues can increase, people’s experiences of accessing services may be improved.