Background: Diabetic retinopathy (DR) is the leading cause of blindness in the working population. Adherence to screening guideline will help in the prevention of blindness. General practitioners (GPs) are the 1st line in management of diabetic patients. This study aims to determine their knowledge, attitude and practice toward diabetic retinopathy and to identify factors that affect their practice. Material and method: We conducted a cross-sectional study among a comprehensive sample of the GPs who work at primary health care units of Tabuk city from July to December 2017. A validated self-administered questionnaire was used for data collection. Statistical analysis was performed by using Statistical Package for the Social science (SPSS) version 20. Results:  A total of 87 general physicians completed the questionnaire (a response rate of 100%). Only 24.1% of GPs could identify pregnancy as a risk factor. Only 43.7% and 28.7% were aware of retinal detachment and vitreous hemorrhage as complications of DR, respectively. Only 27.6% of the GPs referred type I diabetic patients to an ophthalmologist as per the guideline. The gender difference in referral pattern was found to be statistically significant (p=0.041). Major challenges that may prevent GPs from doing funduscopy were unavailability of ophthalmoscope (42.5%) and lack of skills to detect signs of DR (40.2%). Conclusion: This study found areas of weakness in the knowledge of GPs toward DR including risk factors, complications and screening guideline. Courses and training sessions are recommended as suitable remedial measures.