OBJECTIVES:  To explore the patient's satisfaction with ambulatory care pharmacy services at Riyadh city in Saudi Arabia METHODS:  It is 4-months cross-sectional survey of Patients satisfaction of Ambulatory care pharmacy services at Riyadh city in Saudi Arabia. The survey consisted of Forty-Eight questions divided into two-part demographic information and the second part with eleven domains. It included medication availability, patient counseling, pharmacist and patient relationship, medication reconciliation, medication aberrance, pharmacy location. Pharmacy waiting area, pharmacy communications, pharmacy waiting time, overall patient satisfaction of pharmacy services. The 5-points Likert response scale system closed and ended questions used. The survey distributed through three public, pediatrics, and emergency hospitals ambulatory care patient. The authors did the interview with the patient with electronic survey documentation. It analyzed through survey monkey system RESULTS:  The total responders were (606) Patients. Of those 509 (84.3%) was Saudi and 95 (15.7%) was non-Saudi. The gender distribution 338 (55.8%) was female, and 268 (44.2%) was male and the majority of them in age (18-44) 65.3%. The scores of medication availability domain were (3.35), patient counseling was (3.2), pharmacist and patient relationship were (3.7), and medication reconciliation was (1.96). The medication adherence was (1.8), pharmacy location was (3.7), pharmacy waiting area was (3.25), pharmacy communications was (2.14), pharmacy waiting time was (3.61), pharmacy recommends to others was (3.54). General evaluation of pharmacy services was very good-excellent with 381 (62.87%) of responders, while 369 (60.9%) advised the pharmacy to his family or friend and 315 (52.5%) of responders prefer to visit pharmacy again. CONCLUSIONS:  A half of patients satisfied with ambulatory care pharmacy services at Riyadh city. The patients were not happy with medication reconciliation services, medication adherence, and pharmacy communications system. Improving ambulatory care pharmacy services will prevent drug misadventures, avoid additional cost, and raise patient satisfaction of pharmacy services.