Objectives: To investigate the contribution of general and family medicine to strengthening primary health care (PHC) and advancing disease prevention in Saudi Arabia, and to identify system-level enablers, barriers, and opportunities for optimizing preventive service delivery.

Methods: A cross-sectional mixed-methods study was conducted among 200 PHC physicians across urban and semi-urban centers in Saudi Arabia. A structured, validated questionnaire assessed core family medicine functions, preventive activities, organizational support, and perceived barriers and opportunities. Quantitative data were analyzed descriptively and inferentially; qualitative insights were integrated to contextualize findings. Instrument reliability was confirmed via Cronbach’s alpha (α ≥ 0.70).

Results: The majority of physicians (90–95%) reported active engagement in core PHC functions—first-contact access, continuity, comprehensiveness, coordination, and patient-centered care—and consistent implementation of preventive services, including lifestyle counseling, screenings, and adherence to national guidelines. System-level support, including staffing, clinical guidelines, referral pathways, and management endorsement, was perceived as adequate. Key barriers included time constraints and limited patient awareness, while opportunities encompassed expanded family medicine training, digital health integration, and enhanced public engagement.

Conclusions: General and family medicine constitutes a critical pillar of PHC in Saudi Arabia, supporting continuity, comprehensiveness, and preventive care. Targeted interventions addressing workforce capacity, patient awareness, and digital integration are likely to further optimize PHC performance, informing policy and practice strategies aligned with Saudi Vision 2030.