Background: Despite the high demand for organ donation, inadequate organ availability remains an issue. Many barriers are associated with this demand-supply gap. Low public awareness, religious beliefs, gap in knowledge, negative attitudes, and cultural justifications are suspect barriers to organ donation. The objective of this study was to compare Saudis’ knowledge and attitudes toward deceased organ donation between those who registered as donors and those who are not.

Methods: A cross-sectional, study-specific questionnaire was conducted. Through convenient sampling, the questionnaire assessed knowledge and attitudes and compared them among those who registered for organ donations versus those who had not. Independent t-test was used to analyze between-group differences.

Results: Data was collected from 3,111 individuals with a mean age of 31.4 years (SD = 9.7). The result of the independent t-test showed a nonsignificant difference in the mean level of knowledge (t = 1.2, p = .247) between participants who registered for deceased organ donation and those who did not. The result of attitude indicated a statistically significant difference between the two groups (t = -30.5, p < .001).

Conclusion: The study revealed that Saudis’ knowledge about deceased organ donation may not be driving their decision to register. Attitudes seem to be more influential in shaping that decision. Knowing this, public health practitioners might need to focus on initiatives that shift the public mindset and create a new social norm as opposed to providing facts and information.

Key words: Deceased organ donation, knowledge and attitudes, after death organ donation, registration, Saudi Arabia