Background: Spinal cord injury (SCI) is always a medical emergency as it could lead to chronic painful conditions, permanent paralysis or even death. Objectives: Assessing the knowledge, attitude and practice (KAP) regarding the first aid of spinal injury in Kingdom of Saudi Arabia (KSA). Methods: A prospective randomized controlled study based on a questionnaire sheet that was conducted at Saudi Arabia, from March to July 2018.The study included 390 medical students randomly chosen from different faculties of medicine around KSA. Results: The level of knowledge was sufficient among 84.9% of medical students. The attitude of the medical students was good among most of the participants regarding calling help and starting CRP immediately, taking care while moving the patients and applying direct pressure on the side of bleeding. The level of practice among most of medical students was good toward patients with spinal injury even conscious or not. Conclusion: The KAP level was sufficient among medical students about first aid of spinal injury. The proper knowledge, positive attitude and practice skills towards first aid can make a significant difference in Saudi Arabia.