Introduction: Although patients undergoing elective surgery are assumed to have a lower level of preoperative anxiety, studies reported a high level of anxiety among those patients. . This study aimed at assessing the level of preoperative anxiety and its predictors in adult patients undergoing elective surgery. Methods: This study is a cross-sectional design conducted among patients admitted for elective surgery. A total of 278 patients with non-life-threatening surgeries were included and those who had mental or psychological problems were excluded from this study. Sample type and sample size. The data collected through a questionnaire about demographics, preoperative knowledge and anxiety in the preoperative room 24 hours before the operation. The frequencies, percentages, mean and SD were calculated, and t-test was used to detect significant associations. Results: The overall preoperative anxiety score had a mean ±SD of 18.2±5.8 and the questions regarding knowledge component reported higher scores than those about anxiety component. The components of anxiety about surgery reported higher scores than those of anxiety about anesthesia.   Age, gender, availability of family support and type of surgery were found as significant predictors for preoperative anxiety prior to elective surgery. However, the association between preoperative anxiety and marital status and previous experience of surgery were found statistically non-significant. Conclusion: This study concluded that patients underwent elective surgery had high preoperative anxiety. The patients with younger age, female gender, patients under general anesthesia, or those who had no family support showed a higher level of preoperative anxiety.