Background and Objectives: this study aimed at assessing the level of compliance among contact lens wearers with hygiene rules, the prevalence of associated eye complaints, to determine the demographic factors of compliance and eye complications. Material and Methods: this is cross-sectional study on 500 subjects' contact lens wearers at three ophthalmology clinics in Saudi Arabia (King Abdul-Aziz University Hospital in Jeddah, King Khalid University Hospital in Riyadh and King Fahad University Hospital in Khobar) during the period between July 2017 and March 2018. A semi-structured questionnaire was administered to investigate 10 items with a compliance score (0-10) was calculated as the number of rules to which the participant is fully compliant. Socio-demographic data were analyzed as factors for compliance and correlation of compliance scores with the presence and number of ocular complaints. Results: contact lenses were used for cosmetic purpose (47.8%), and for refractive errors (38.6%); and most frequent lens type was monthly (42.6%). Results showed that 22.6% of participants changed sterile solution daily; 15.8% changed the lens box monthly, 81.2% washed their hands before, 89.6% washed lens before and 33.2% after wearing the lenses, and 37.2% followed the correct washing method. The mean (SD) compliance score was 4.67 (1.60) and females had a moderately higher score than men. The majority of participants (93.0%) reported eye complaints and 73.6% had two or more concomitant symptoms. Conclusion: contact lens wearers have poor compliance with several hygiene rules resulting in the high prevalence of eye complaints. Therefore, it is important to teach contact lens wearers the specific hygienic rules of the target population to prevent serious eye complications.