Background: Inappropriate use of antibiotics is known as an important risk factor in the development of antibiotic resistance, which increases the morbidity and mortality. We aimed to determine the prevalence and characteristics of antibiotic use in a Tertiary Care Hospital in Tabuk city, Northern Saudi Arabia. Methods: A cross sectional study was conducted in a Tertiary Care Hospital in Tabuk city, during October 2017.  Results: A total of 120 participants, 107 of them had antibiotics in their prescriptions with antibiotic use prevalence 89.2%. Most of patients were males (62.6%) and children and adolescents (0-19 years) constituted 4.8%. The most attended department was internal medicine (32.7%). 21 diseases were identified, upper respiratory tract infection (URTI), followed by urinary tract infection (UTI) 8.4%. Among the antibiotics, ampicillin, cephalosporin and metronidazole were the most prescribed antibiotics as each of them was found in 16.8% of cases, followed by quinolones in 12.1% and macrolides in 11.2%. In addition, Augmentin (9.3%), aminoglycosides (7.5%) and chloramphenicol (1.9%).  Regarding the combined therapy, 31.8% of patients received combination of two antibiotics, 4.7% received three antibiotics and only one antibiotic was prescribed in 68% of patients. The most common route of administration was the oral tablets in 48.6% and syrup in 14% of patients. Conclusion and recommendations: The prevalence of antibiotic use in Tabuk Tertiary Care hospitals was very high (89.2%) which could be a risk factor for the development of antibiotic resistance. We advocate public health measures targeting healthcare providers on the use and misuse of antibiotics.