1524 Background: Despite the relatively low incidence in the Kingdom of Saudi Arabia (KSA) compared to Western countries, breast cancer (BC) is the most common cancer among Saudi females for the past 11 consecutive years (National Cancer Registry 1994–2004). The objective of this study is to report the results of the first public national BC screening program in KSA and to evaluate the relationship between imaging and pathological findings and known BC risk factors. Methods: Asymptomatic women 40 years of age or older underwent BC screening at Abdulatif Charitable Cancer Screening Center, Riyadh, KSA. Mammograms were scored using American College of Radiology Breast Imaging Reports and Data System (BIRADS). Correlations between imaging findings and risk factors, as well as pathological findings, were analyzed. Results: A total of 1,215 women were enrolled between September 2007 and April 2008. Median age was 45 years (19–91) and median body mass index (BMI) was 31.6 kg/m2 (16.7–58). A total of 16 cases of cancer were diagnosed (80% are less than stage IIB). No cancer was diagnosed in 942 women with R1/R2 scores and only one case of cancer was diagnosed in 228 women with R0/R3 scores. However, among 26 women with R4/R5 scores, 50% had malignant disease and 35% had benign lesions (odds ratio = 1.96; 95% confidence interval = 1.5, 2.6) (p < 0.0001). No correlation between known risk factors and imaging score or cancer diagnosis. Conclusions: The public acceptance of BC screening program was encouraging. Longitudinal follow-up and inclusion of more participants will help in better determining the risk factors relevant to our patient population. No significant financial relationships to disclose.