Background: Body image has been defined as the person's perceptions, thoughts, and feelings about his body. Body image dissatisfaction is a problem of growing concern that affects psychological wellbeing. Objectives: This study aims to estimate the prevalence of body image dissatisfaction, identify its underlying risk factors, and explore the relation between actual, perceived and desired BMI among female medical students in Taibah University, KSA. Method: This is a cross-sectional survey that involved 242 participants. Data were collected using a nine figure silhouette rating scale for assessing body image dissatisfaction, a self-administered questionnaire for identifying possible factors contributing to dissatisfaction, and measurement of the participants' weight and height to calculate their actual BMI. Results: Of all participants: 26.4% were satisfied, 18.6% perceived self as too thin, while 55% perceived self as too heavy. There has been a significant association between the degree of satisfaction and the following factors; actual BMI, family influence, friends' criticism, unreal self-perception and feeling of disproportional body parts (at P < .05). The actual and desired BMI of the participants in the study have been correlated to their perceived BMI at a significant level (P = .000). Conclusion: Dissatisfaction was prevalent and associated with actual BMI. The majority of participants were dissatisfied, overestimating their weight and desired to be thinner. Exercise and diet were commonly used to control weight. Further researches need to be done on this topic on a larger population of the Saudi community taking in consideration its association with depression and eating disorders.