Aim: To determine the pattern of smoking and associated factors among intermediate and secondary school boys. Methods: This cross-sectional study was carried out on a random sample of third-grade intermediate, and three grades secondary school male students within Alkhobar city area, eastern province of Saudi Arabia. A structured self-administered questionnaire was used for data collection. Prevalence of smoking among the teachers in the same schools was also investigated. Results: The sample was 1240 students, selected from 11 schools, with a mean age of 16.5±1.82 years. The number of students who practiced smoking [Hubble-bubbly and cigarettes] was 196 [14.1 %]. Those who smoked cigarettes were 187[13.5%], while 115[8.3%] smoked Hubble-bubbly, and 53[3.8%] smoked only one of them. The majority of smokers [88.2%] started to smoke after the age of 11 years, for more than 3 years, to have the experience of it. There were significantly more smokers among students who reported fair or poor relationship with their fathers [P< 0.001], siblings (P < 0.006], or between their parents [P< 0.002]. There were significantly more smokers among students who had a high score of knowledge about the toxic substances of cigarettes [P<0.00001], and risks of cigarette smoking [P < 0.01]. Out of 142 teachers, there were 31 [21.8%] who practiced smoking. Conclusion: A high prevalence of smoking was found among male intermediate and secondary school students in the Al-Khobar area. Unstable relationships in the students' family may be a predisposing factor for this habit. Initiation of smoking prevention / cessation in schools is urgently needed.