Background: Self-treatment, treatment of closed relatives and friends compromises the professional objectivity and these are important medical ethical issues that pose big professional challenges to the physicians. Objectives: To assess the prevalence of self-treatment and treatment of close relatives (TCR) among primary healthcare (PHC) physicians and to investigate factors, perceived risks and ethical awareness related to this practice. Methods: This questionnaire-based cross-sectional was study conducted by randomly selecting 15 PHCs in Western region of Saudi Arabia between April and May 2016 at the Family and Community Medicine Department, Medical College, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia (KSA). Physicians from all specialties replied anonymously to the questionnaire. Results: Eighty PHC physicians were recruited, 52.5% females, 77.6% aged below 40 years; majority were general practitioners (61.3%) with 0-5 years of practice (53.8%). The prevalence (95% CI) of selftreatment, self-prescribing and self-prescribing of controlled substances was 87.5% (80.3; 94.7); 90.0% (83.4; 96.6) and 7.5% (1.7; 13.3) respectively. Prevalence of practices related to TCR ranged from 6.3% for surgery to 93.8% for physical examination performed on a close relative. Sense of responsibility, illness being among scope of practice and minor illness were the three most frequent motivations for TCR. Compromising physician ’ s objectivity, family quarrels and patient to conceal sensitive information were frequently perceived risks for TCR. Regarding ethical awareness, majority of the participants (68.8%) declared not being aware of international guidelines and minority would agree to classify self-treatment and TCR as not recommended. No association was found between practice and demographics or ethical awareness. Conclusion: Self-treatment, TCR and related practices are highly prevalent among PHC physicians in Saudi Arabia despite appropriate perception of associated risks.