Purpose: Despite the unquestionable role of the primary care physicians in carrying the majority of high-quality care for patients under palliative care is well-known, especially with the senior population, it is still not clear what their existing level of knowledge and attitude toward palliative care is. Unfortunately, there is limited research. So, we aimed at detecting the knowledge and attitude of the primary care physicians toward palliative care in Kuwait. Patients and Methods: A survey using the Palliative Care Attitude and Knowledge questionnaire (PCAK) applied to twenty-five primary care clinics in Kuwait was selected by stratified random sampling method and 284 physicians were included. Results: The response rate was 79.2%(n=225). The uncertain attitude toward palliative care was reported in 53.3% (n=120) of primary care physicians while only 15(6.7%) had good knowledge. Only 31.2% reported excellent or very good experience in the management of pain and other symptoms respectively. Moreover, unfamiliarity with palliative care services in their community or length and types of coverage under palliative care benefits was reported in 141(62.7%) and 119 (52.9%). Regarding opioid initiation, types, toxicity and its role in refractory dyspnea, and the proper management of catastrophic bleeding, less than 50% responded appropriately. A higher knowledge score was a positive prognosticator for more optimistic attitude scores (OR: 1.088, 95% CI: 1.012-1.170, P-value: 0.023) Conclusion: The uncertain attitude and poor knowledge were reported in the majority of primary care physicians toward palliative care. Integrating palliative care into primary health care systems has to be initiated as possible to lessen the suffering of those patients and to meet the challenges of the ageing society.