Self-rated health reflects a person's integrated perception of health, including its biological, psychological, and social dimensions. It is a predictor of morbidity and mortality. To assess the current status of self-rated health and associated factors in the Kingdom of Saudi Arabia, we analyzed data from the Saudi Health Interview Survey. We conducted a large national survey of adults aged 15 years or older. A total of 10,735 participants completed a standardized health questionnaire. Respondents rated their health with a five-point scale. Data on socio-demographic characteristics, chronic diseases, health-related habits and behaviors, and anthropometric measurements were collected. Associated factors of self-rated health were analyzed using a backward elimination multivariate logistic regression model. More than 77% of respondents rated their health as excellent/very good. Female sex [odds ratio (OR) 1.52, 95% confidence interval (CI) 1.24-1.88], decades of age (OR 1.35, 95% CI 1.25-1.46), diagnosed diabetes mellitus (OR 1.54, 95 CI 1.22-1.93), diagnosed hypercholesterolemia (OR 1.37, 95% CI 1.06-1.79), diagnosed hypertension (OR 1.55, 95% CI 1.22-1.96), number of other diagnosed chronic diseases (OR 1.69, 95% CI 1.41-2.03), limited vigorous activity (OR 3.59, 95% CI 2.84-4.53), need for special equipment (OR 2.62, 95% CI 1.96-3.51), and more than 3 h of daily television/computer screen time (OR 1.59, 95% CI 1.11-2.29) were positively associated with poor/fair health. Smoking, obesity, and physical inactivity were not associated with self-reported health. We found that preventable risk factors are not associated with Saudis' self-rated health. This optimistic perception of health poses a challenge for preventive interventions in the Kingdom and calls for campaigns to educate the public about the harm of unhealthy behaviors.