Objectives: To report the occurrence and determinants of adult BA in Al Baha area, south western Saudi Arabia. Methods: A cross-sectional study was done on adults visiting primary health care (PHC) centers. The Arabic form of the ISAAC survey was used. The occurrence of wheeze in the previous 12 months was exercised to specify the occurrence of BA. Results: The study comprised 821 persons. The prevalence rate of BA was 17.7% (95% CI: 15.2 – 20.4). Those having wheezes in the past year had up to 3 attacks of wheezes (116, 80%), sleep disturbance once (45, 31%), wheezy chest after exercise (67.6%, 98) and dry cough at night (69.0%, 100). In a multivariable analysis, determinants significantly associated with BA were; living in rural regions (aOR = 2.25, 95% CI: 1.50 – 3.39), ever smoked (aOR = 1.78, 95% CI: 1.15 – 2.75) and having cats at home (aOR = 2.70, 95% CI: 1.15 – 6.34). Conclusion: The prevalence of BA in Al Baha denotes a public health issue. The study revealed some modifiable factors significantly associated with BA in adults. There is a necessity to adjust asthma screening activities at PHC level particularly at countryside areas. In addition, improving community-based health promotion programs including smoking cessation are needed.