BackgroundPregnancy is a unique physiological condition in which medication intake offers a challenge and a worry due to changed drug pharmacokinetics and drugs potentially crossing the placenta, such as beta blockers and benzodiazepines. As a result, medication safety during pregnancy has gained global interest, attracting attention from doctors and pregnant women, little of which has been documented regarding the Saudi population. Therefore, this study aimed to assess medication use and perceptions of medication use during pregnancy and breastfeeding among women in Saudi Arabia. MethodsThis study is a questionnaire-based, cross-sectional study. Data was collected through an online selfadministered questionnaire from different regions of Saudi Arabia. Data was then entered and analyzed using SPSS 24.0 version (IBM Inc., Chicago, USA) statistical software. ResultsA total of 1831 participants were included in the current study. About 835 (45.6%) of the participants were within the age group of 26-35 years old. A total of 602 (32.9%) were using medications on a daily basis or several times a week during pregnancy or breastfeeding. About 1476 (80.6%) participants agreed on medication use during pregnancy. About 66.4% of women would be worried about fetal malformations if they were supposed to take medications during pregnancy. About 940 (51.3%) women think that medication use during early pregnancy is harmful, and 500 (27.3%) think that medication use during breastfeeding trimesters is harmful. Regarding pregnant women's perception of herbal medicines, about (65.4%) of those with low educational levels think that herbal medicines are harmful in early pregnancy. Most participants (63%) within the age group of ≥36 years old think that medications and herbal medicines are harmful in early pregnancy. The vast majority (91%) of the participants would ask the physician working on antenatal care if they had concerns about using certain medications during pregnancy. ConclusionThe average use of medication and herbal medicines among pregnant women was noted, although many women had negative beliefs about taking certain medications. Continued effort is essential to support and encourage women to seek out reliable information sources regarding medication use during pregnancy. In addition, healthcare practitioners should be mindful of women's attitudes when counseling them to take medication during pregnancy.