Introduction: Autism spectrum disorder is a complicated neurological disorder that is characterized by behavioral and psychological problems in children. A wide spectrum of factors has been monitored in many studies, which are related to the autism spectrum, including genetic, environmental, and parental factors, including those associated with pregnancy, obstetric diseases, and so on. Accordingly, this study aimed to determine the risk factors for Autism spectrum disorders in the Saudi population.  

Methods: Case–control study covered 100 Autism spectrum disorders patients and 100 healthy group-matched controls recruited from King Salman armed forces hospitalsautism center in 2021. The data was collected from the records and analyzed using SPSS 28.0.  

Results: The study found that lower maternal education, rural residence, maternal unemployment, positive family history for autism, maternal stress and uptake of MMR vaccine uptake were identified as significant risk factors associated with autism in invariable analysis (p values < 0.05 in all). In this study, multivariable/logistic regression analysis found that rural residence (AOR = 129.4, 95% CI 40.6 – 411.8, p < 0.001), positive family history of autism (AOR = 9.4, 95% CI 1.04 – 85.04, p = 0.046) and, and maternal distress (AOR = 2.8, 95% CI 1.53 – 5.1, p = 0.001) were identified as risk factors associated with ASD.  

Conclusion: Our study suggested that maternal stress, rural residence and family history of autism are significant risk factors for ASD. Identifying these risks and protective factors associated with ASD will not only help us understand its prevalence but may also constitute important preventive measures.