OBJECTIVES: There is lack of Arabic version of AOTBA scale. In order to make this scale readily understood by Arab subjects in the target population, a translation into the Arabic language with a linguistic validation are needed. Such validation requires some cultural adaptation documenting that each word translation adequately captures the concepts of the original English-language version of the questionnaire. The objective of this study was to produce translations that are conceptually equivalent to the original versions, ensuring the relevance of the translations within the target culture.  METHODS: A standard methodology was employed for linguistic validation: 1 forward and 1 back translation, review and developer review; or an in-country review and developer review; linguistic validation interviews with 10 subjects, a mix of healthy people and patients, a second developer review and 2 proofreadings. Participants were asked to identify any words that were difficult to understand and explain in their own words the meaning of each sentence in the questionnaire.  RESULTS: Translations of the AOTBA questionnaire from English to the Arabic language were well understood by the participants with an overall comprehension rate across language of 96%. The translations retained the original meaning of the AOTBA items and instructions. Comprehension difficulties were identified, and after review by the translation team, minor changes were made to improve clarity and comprehension. The translation process highlighted numerous cultural and linguistic issues, therefore, clarifications and modification were made as appropriate by using alternative verb formations and formatting. CONCLUSIONS: The AOTBA Scale has been translated and linguistically validated using a rigorous translation process. A number of cultural and linguistic issues became apparent and were resolved. Conceptual, semantic, and cultural equivalence of each translation of the AOTBA questionnaire was achieved thus confirming linguistic validation. Further validations steps are need for scale use in multinational trials.