To investigate the incidence and accountable factors for the potential dropout thoughts among Saudi medical students. A cross-sectional survey questionnaire based study was conducted among Saudi medical students enrolled at the College of Medicine, King Saud University. A total number of 587 (39.13%) medical students out of [approximately]1,500 filled the questionnaire. Among them 302 (51.4%) reported incidence(s) of dropout thoughts at least once. However, only 17 (5.6%) have thought of dropping out very seriously. The majority of the students (67.5%) thought for withdrawal only on stressful days. The first year of the medical school was the most common year for all the students (49.3%) for thinking of dropout and academic problems were the most common reasons behind dropout thoughts (37.8%). The students, whose decision for entering in the medical school was influenced by the surroundings were at higher risk of dropout thoughts than their peers (OR = 1.912, CI 1.33-2.75). A significant amount of dropout thoughts was prevalent among Saudi medical students, but serious thinker about dropout were less in numbers. A well-structured academic guidance program supported with psychological teaching method must be designed and offered to diagnose the symptomatic students before actually they get affected with dropout thought which might lead to actual dropout.