Background and objectives: Refractive errors (RE) is one of the most common causes of vision impairment among children, but little is known about its prevalence among pre–school children in certain Saudi regions, including Madinah city. This study aimed to measure the prevalence of uncorrected RE among pre–school children attending kindergartens in Madinah city, Saudi Arabia.

Methods: A pre–school –based cross–sectional study was carried out in Madinah city during the study year 2016/2017. A cluster random sample was taken and included 800 pre–school children (3–6 years) from 12 Kindergartens. The studied pre–school children were screened to diagnose uncorrected RE using auto–refractometer. The prevalence of different types of uncorrected RE were estimated among the studied children. Appropriate statistical analyses, including logistic regression analyses were performed.

Results: The response rate was 94% (750 out of 800). The prevalence of uncorrected RE in the studied 750 children was (8%; 95% CI= 6.1%–9.9%) with significant differences by age group. The prevalence was 3.6% for myopia, 3.3% for astigmatism, and 1.1% for hypermetropia. Risks for uncorrected RE among studied pre–school children were positively associated with age and this was marked in myopia and astigmatism. Myopia was associated more with girls, while hypermetropia was associated more with boys.

Conclusions: The prevalence of uncorrected RE was high among pre–school children aged 3–6 years attending kindergartens in Madinah city. Establishment of vision screening programs for pres–school children attending kindergartens in Madinah is crucial to reduce the undesirable future effects of uncorrected RE among them.