Background: Prescribing errors are common, rarely fatal but can prolong the duration of illness. Additionally, illegible hand writing or using uncommon abbreviations can lead to prescribing inappropriate medications. Objectives: To evaluate prescription writing skills of physicians working in primary health care centers, Ministry of Health (MOH). Methods: Multi-center analytical cross-sectional study was carried out including a random representative sample of manual prescriptions issued by physicians working at MOH primary health care centers inside Makkah Al-Mukarramah. A self-constructed validated checklist was used to assess the prescriber’s certificate and job description, legibility of hand writing and fulfillment of certain information about the prescriber, the patient and the medications. Results: The study included 348 prescriptions; more than half of them (57.2%) were written by specialists. All words were legible among 29% of prescriptions whereas among 15.2%, only few words were legible. Patients` name was written and prescriber`s signature was present in all prescriptions while patient weight was present in minority of prescriptions (4%). Prescriber`s stamp was present in 88.5% of prescriptions. Overall, only 0.9% of prescriptions were without errors of minor omission and 39.7% of prescriptions were without errors of major omission in the first drug and only 5.5% in the 6th drug. Conclusion: Different types of prescription errors are quite common among primary healthcare physicians in Makkah. Fortunately, minor errors are more frequent than major errors. Errors in general were more frequent among resident, MBBS holder and low experienced physicians.