Introduction: Depression in elderly is a disabling disease that affect quality of life. It is under–recognized and undertreated. The aim of this study is to asses physicians perception and practice toward depression in elderly in KSA.

Method: a cross sectional study conducted in eastern providence.A self–administered questionnaire was sent to all PHC physicians in Dammam, Alkobar and Alqatif cities.

Results: thirty six percent of physicians had adequate general knowledge. Better knowledge level is associated with attending postgraduate courses. Physicians reported positive attitude toward depression in elderly. Positive attitude was associated with attending the postgraduate courses. One–third of PHC physicians do not assess depression in elderly.

Conclusion: PHC physicians‘ knowledge was poor, their attitude is positive. Postgraduate mental and geriatric care courses improve PHC physicians‘ perception.

Recommendation: effective postgraduate courses in geriatric and mental care should involve all PHC physicians to ensure better care for elderlies.