Background: surgical site infections (SSIs) are microbial contamination of the surgical wound during a period of one month that could result in major post-operative morbidity and mortality rates. Objectives: this study aimed to identify the adhesion of surgeons to antibiotics prophylaxis guidelines at Kingdom of Saudi Arabia (KSA). Methods: this study included 180 adult subjects who were scheduled to undergo major surgeries in the hospital. The data of the patients were collected from the surgical wards and day care unit. Results: most of the included surgeons showed no error during pre, intra and post operative duration as give the required antibiotics and didn't give the non-require antibiotics. The preoperative adherence of surgeons as most of the surgeons (73.9%) followed the prophylactic measures that included correct choice, indications, dosage and duration. Most of the surgeons (76.1%) followed the prophylactic measures including correct choice, indications, dosage and duration during intra-operative period. The majority of the surgeons (75%) followed the prophylactic measures including correct choice, indications, dosage and duration during post-surgical duration. Conclusion: The level of surgeon's adherence to antibiotic prophylactic guidelines was efficient among most of surgeons regarding the proper choice of antibiotic, duration, timing and indication. However, these results differ from other available studies, this study showed a good sign for application of antibiotic prophylactic measures in KSA hospitals. Further studies should be conducted to increase the knowledge and adherence of surgeons all over KSA.