Prostate cancer (PC) is the third most frequent cancer in the eastern region. Screening may prevent death or metastasis. However, the risk of false–positive results, overdiagnosis and other complications after screening is a significant issue. Primary health care physicians (PHCP) should be aware of the recent recommendations about PC screening. Aims: To assess knowledge and practice of PC screening and counselling among PHCP. Methods and Material: A cross–sectional descriptive study Study population & settings: All PHCP at Ad Dammam city Ministry of health. Results: A significant proportion are offering screening outside the recommended age (42.5%). Most respondent chose PSA as screening tool (78.8%). About two thirds (61.3%) agree that PSA screening has high false–positive results. Long experience, working in geriatric clinic, Follow PC patient or high postgraduate qualifications are significantly increase knowledge about PC. 52% frequently offers to screen for asymptomatic patient in the age group 55–69. Older physicians, those who have longer experience and those who see more patients are more likely to screen. 10% would counsel every patient about the benefit and harm of screening, while 35% would never counsel before the screening. The odds of practicing prostate cancer screening is 5 times higher for those who did not attend the training course. OR 5.0.54 (95% CI 1.062 to 24.06). Conclusions: Our findings suggest that PHCP should be aware about the recent recommendations. The need for national PC screening guideline is essential. PHCP should attend cancer screening course or have post graduate qualifications to be aware about the recent recommendations. Also, they should work in geriatric clinic or urology clinic during their undergraduate or postgraduate training to increase their knowledge