Aim: To assess the knowledge, attitude and believe regarding influenza vaccination in family medicine residents. Material and Methods: A cross-sectional study was carried out among family medicine residents at Makkah Al-Mokrramah joint program, Saudi Arabia. A questionnaire was administered by web based survey in September – November 2020. It composed of 5 sections; general information of participants, their awareness, knowledge, attitude and practices regarding influenza vaccine. Results: One hundred and sixty three (n=163) family medicine residents have included in the final report. More than half of them (51.5%) were females. Almost half of them (49.7%) were aware of the published guidelines Advisory Committee on Immunization Practices (ACIP), Scientific Committee for Influenza and Pneumococcal Vaccination (SCIPV) or CDC for influenza immunization; particularly among R4 residents, p=0.034. Male physicians were more likely than females to believe that administering the influenza vaccine should be part of their medical practice (91.1% vs. 78.6%), p=0.026. Most (76.1%) of the family medicine residents have taken routine vaccination against influenza. Among those who did not routinely vaccinated against influenza (n=39), the main reasons were believing that the vaccine will make them sick (43.6%), dislike needles (17.9%), no big deal as they had flu before (17.9%) and believing that the flue is not so serious (17.9%). The commonest reported barriers preventing family medicine physicians from giving influenza vaccine to some or all patients were concerns regarding vaccine safety for patients (54.0%), availability (42.3%) and concerns regarding vaccine safety for them (30.7%). Discussion: Knowledge level of family medicine residents in Makkah Al-Mokrramah regarding influenza vaccination is acceptable in many parts; however it is defective in some other parts. Their attitude is overall encouraging and coverage rate is acceptable, but can be improved.