Background: Breaking bad news is a critical skill for healthcare providers that require sensitivity, empathy, and effective communication. By utilizing structured approaches like the SPIKES protocol, providers can navigate these difficult conversations more successfully, ultimately improving patient care and satisfaction. The study aimed to examines skills and attitudes of physicians in Saudi Arabia's eastern region in delivering bad news to patients based on the SPIKES protocol. Research design: a cross-sectional multicentre study. Sample: 294 physicians of different specialties. Tools: Physicians characteristics and training of delivering bad news, self-administered questionnaire involved physicians' knowledge and skills regarding BBN and the breaking bad new attitude scale (BBNAS). Results: The study showed that 46.5% and 36.84% of residents rated their perceived competence in BBN and managing the patient's emotions during BBN as good or very good respectively with a total mean and standard deviation of SPIKES score 0.6135 ± 0.29605. In addition, the cumulative mean and standard deviation of physicians' attitudes towards the training about BBN are 0.6148 ±0.36572. Conclusion: The current study findings showed that less than half and more than one third of residents rated their perceived competence in BBN and managing the patient's emotions during BBN as good or very good. According to the findings, BBN skills and attitudes are not significantly correlated with hospital work experience or the individuals to whom bad news is delivered. A positive correlation was found between BBN skills and attitudes and receiving education or training on patient rights. Time of taking education on patient rights was significantly negatively correlated with BBN skills.