Introduction: Globally, Atherosclerotic Cardiovascular disease is responsible for 17.7 million deaths yearly, representing almost one third of deaths globally. Its modifiable risk factors are hypertension, diabetes, overweight or obesity in addition to smoking, and physical inactivity. Saudi economic evolution over the past decades brought up significant increase in life expectancy and substantial modifications in lifestyle as well as it promoted prevalence of such risk factors. Objective: to shed light on the prevalence of ASCVD major modifiable risk factors and their trend if any in Saudi Arabia. Methodology: We searched published literatures that have addressed prevalence of modifiable risk factors of atherosclerotic cardiovascular disease in Saudi Arabia via the internet, using the medical database MEDLINE/PubMed. Retrieved articles were reviewed by authors. We excluded hospital-based studies or none original papers. Selected articles that matched the criteria were included in this review. Results: in this review article we reviewed 21 epidemiological articles that highlighted the prevalence of atherosclerotic cardiovascular disease modifiable risk factors in Saudi Arabia. The real challenges are some risk factors are asymptomatic and underdiagnosed, poorly controlled and they are linked in a way that addition of one risk factor may lead to another one or aggravate it. The trend of such risk factors is growing, and programs should be in place to slow down their growth. Conclusion: There is a need for more comprehensive awareness programs to publics aiming to promote healthy lifestyle and enhance early detection and adherence to treatment.