Background: Lower gastrointestinal bleeding is known as hemorrhage which originates from the lower gastrointestinal system. Undergraduate students must have adequate knowledge of this topic to help them in their practice and to be effectively engaged with their patient's assessment and diagnosis.
Objectives:  This study aims to assess the awareness and knowledge among medical students about lower gastrointestinal bleeding etiology in the governmental universities of Riyadh, Saudi Arabia.
Materials and methods: This cross-sectional study was conducted using a prepared electronic self-reported questionnaire among medical students at four different universities in the Riyadh region. After collecting the data, MS Word was used for data entry while SPSS version 23 was used for data analysis.
Results: In this study, a total number of 1,129 responses were collected from students at four different universities. Most of the participants (61.6%) were between 21-23 years old. In general, it was shown that 58.2% of students have enough knowledge regarding the symptoms related to lower gastrointestinal bleeding. Moreover, the participant medical students have chosen the hemorrhoids (33.2%) to be the leading cause followed by diverticulosis (20.0%), and anal fissures (11.1%).
 Conclusion: It was found that among the more than 1000 medical students in Riyadh region, Saudi Arabia, the awareness level toward symptoms and causes of lower GI bleeding is inadequate. There is a need to improve the awareness of medical students regarding lower GI bleeding presentation, particularly those in pre-clinical years.