Context: Public awareness regarding cosmetic surgery. Aims: To assess the attitudes and acceptance of cosmetic surgery among patients in a tertiary care hospital in Riyadh, Saudi Arabia. Settings and Design: Single-center, cross-sectional study in the family medicine department at our institution. Methods and Material: Data were collected from 389 patients (age 15-50, 29.37 ± 9.25 years, male: female = 139:250) using the Acceptance of Cosmetic Surgery Scale (ACSS) modified for Arabic speakers. Statistical Analysis Used: SPSS 22 statistical package. Results: One hundred eighty-five (47.6%) patients were willing to undergo minor cosmetic surgery, whereas 144 (37.1%) were not. Additionally, 237 (60.9%) patients agreed that cosmetic surgery is good because it can help people feel better about themselves, whereas104 (26.8%) patients disagreed. Robust Cronbach α values were observed among all ACSS scales. Mean significant ( P = 0.002) differences were observed between gender and the intrapersonal scale scores. The average intrapersonal scale score was greater among female patients (22.48 vs. 19.29). Similarly, the mean consider scale scores among female patients (20.92 vs. 17.45; P = 0.001). Mean significant ( P = 0.001) differences were also observed between education and the intrapersonal scale. Conclusions: The results reveal important information regarding the acceptance of and attitudes toward cosmetic surgery in Saudi Arabia. There is an urgent need for regulatory intervention to ensure patient safety and satisfaction.