Background: Regular mammogram screening has been used to detect breast cancer at early stages and has been shown to be effective in reducing breast cancer deaths Objectives: To assess mammography use, its determinants and define barriers to mammogram screening among women in Taif city. Subjects and methods: A cross sectional study was conducted at primary healthcare centers that have breast cancer screening program in the Taif city, western Saudi Arabia. It included a sample of adult women, who were referred to hospitals for mammogram screening but not attended during the study period (1st -31st October, 2019). Data collected by phone regarding cocio-demographic data, history of previous breast lesions, and barriers to mammogram screening. Results: The study included 163 women. The age of almost half of them (49.7%) ranged between 40 and 50 years whereas that of 35.6% of them exceeded 50 years. Previous history of mammogram screening was reported by 47.7% of the participants. Duration since the last done mammogram was one year or less among most of those reported mammogram screening (71.6%). Regarding the age of performing screening mammogram, 44.6% performed it between the age of 40 and 50 years whereas 35.1% did it after the age of 50 years. Results of multivariate logistic regression analysis showed that non-Saudi women were 88% less likely to not performing screening mammogram. However, the p-value was borderline insignificant, p=0.057. Women with no family history of breast cancer were more likely to not performing screening mammogram compared to those with family history of breast cancer (adjusted odds ratio “AOR” =3.24, 95% confidence interval “CI”=1.35-7.76, p=0.009. Personal history of breast cancer was not significantly associated with performing screening mammogram after control for confounders. The commonest reported barriers for screening mammogram were lack of time (31.2%), fear of finding out something wrong (20.6%), mammogram is too embarrassing (20.6%) and too painful (20.6%) Conclusion: Refusal to perform screening mammography is a relatively common health problems encountered by adult women attending primary healthcare centers and referred to perform it in specialized hospitals in Taif. Overcoming the reported barriers to perform mammography is essential for women`s health. Keywords: Mammogram, Barriers, Determinants, Saudi Arabia