Background: Cotinine is the predominant metabolite of nicotine which found in tobacco. At present, smoking cigarettes and hookah are on the rise in the Middle East countries; therefore, the number of people exposed to passive cigarette smoking is increasing too. Objective: To compare the salivary cotinine level in saliva in smokers, non-smokers, passive smokers. Also to combat the wrong opinion that hookah is not harmful. Material and methods: In this cross-sectional study, unstimulated salivary samples were collected from 30 female subjects including students and workers at College of Dentistry, Umm Al-Qura university, Makkah. The study participants were divided into 3 groups (each of 10 subjects) aged 19-50 years; First group: with history of cigarettes or hookah smoking at least one session/day for 20-30 minutes for at least 2 years. Second group: exposed to cigarette smoke or hookah. Third group: non-smoker. TheNicAlert™ (NYMOX pharmaceutical corporation, Canada) nicotine saliva test was used to determine salivary levels of cotinine. Results: Salivary cotinine level was detected in all study groups with the different levels. The highest level was in a group of smokers while 50% of non-smokers showed level one. There were no significant differences in salivary cotinine levels between hookah, cigarette and both smokers and a significant relation between duration and salivary cotinine level.Also a non-significant relation was found between age and salivary cotinine level. Conclusion: Salivary cotinine levels were higher in smokers compared to passive smokers and non-smokers, in descending order.