Urinary incontinence (UI) in women is an awkward, often undiscussed subject, associated with anxiety, depression, social isolation and affecting quality of life. This study aimed to assess primary healthcare physicians’ knowledge and practice in Saudi Arabia’s Eastern Province. This cross–sectional study was conducted in primary healthcare centers of three main sectors (Dammam, Khobar and Qatif) in the Eastern Province by a self–administered survey. The sample size was 120 physicians who completed the questionnaire. Most primary healthcare physicians clearly understood UI, one–third of them routinely asked patients about UI, and about 55% of them commonly encountered UI in their practice. Lack of screening tools, unfamiliarity with available treatment algorithms, and lack of time were the most common barriers. Almost all primary care providers (95.8%) referred UI patients to secondary care. Sixty percent physicians had good overall knowledge, and 52.5% had good attitudes and practices about UI. There was no statistically significant relationship except for job level in relation to knowledge and practice scores. Improved education and basic screening programs and treatment in primary care centers would improve UI detection and management at the primary care level.