Background: Most cardiovascular diseases (CVD) can be prevented by addressing their risk factors. The conventional clinical approach to primary prevention of cardiovascular disease relies on identification and treatment of individual risk factors. There are several guidelines that recommend CV risk assessment tools to support CV prevention strategies (ATP III, European guidelines that include Systematic Coronary Risk Evaluation SCORE 2003, ACC/AHA cardiovascular disease risk 2013 based on Framingham risk score. This study aimed to assess knowledge, attitude and practice of family physician regarding global cardiovascular risk assessment, aiming to improve cardiovascular prevention services. Method: A cross-sectional study conducted among family physicians working in family medicine clinics of Prince Sultan Military Medical City (Riyadh, Saudi Arabia) between November 2019 and June 2020. 188 physicians asked to fill a questionnaire that based on knowledge, attitude and practice questions regarding global CV risk assessment. Results: A total 188 physicians were included in this study. The majority (61.2%) of the physicians were between 25 and 30 years. ASCVD of AHA was the most frequent (75.5%) cardiovascular risk assessment tool used in practice. The majority of physicians often used the cardiovascular risk assessment tools regularly (62.8%). Less than half of physicians believed that assessment tools depend on investigations that patients can afford (46.8%). The majority (58.5%) of the physician had unsatisfactory self-assessment of own knowledge and skills. Unsatisfactory self-assessment of own knowledge and skills was significantly associated with lower knowledge and attitude (49.5% versus 68.1%, p=0.004). Satisfactory self-assessment of own knowledge and skills was significantly associated with higher knowledge and attitude (50.5% versus 29.7%, p=0.004). Conclusion:A high proportion of physicians reported using clinical guidelines for primary CVD prevention. However, laboratory investigations and time constrain were common reasons for not using global CV risk assessment tools. Unsatisfactory self-assessment of own knowledge and skills was significantly associated with lower knowledge and attitude of physicians.