The health promotion practice of nurses working in Saudi Arabia is unidentified. The purpose of this study was to investigate the perceived health promotion practice of staff nurses in Saudi Arabia. This was achieved by surveying the views of nurses (n= 614), doctors (n= 130) and patients (n= 322) in 10 hospitals located in the Eastern Province of the country using a self-report questionnaire. There was agreement that nurses had the necessary skills to promote health in general and had sufficient knowledge to promote health in the three specific areas explored: physical activity, smoking cessation and weight control. However, the findings also showed that the majority of participants wanted nurses to give priority to acute care over health promotion within the hospital setting and that patients dislike nurses asking about health-related behaviours when these are not directly relevant to their presenting health problems. Concerns were also raised about the language and cultural competency of a largely migrant nursing workforce to effectively communicate health promotion messages to patients. In view of the findings, policy-makers in Saudi Arabia need to consider providing appropriate training programmes for nurses to introduce the wider concept of their health promotion role. Health promotion protocols, strategies and standards to support nurses to more effectively implement health promotion with their routine practice are also required. It is suggested that, while reliance on a largely migrant workforce who do not speak Arabic continues, the potential benefits of a good quality interpretation service to improve nurse–patient communication should be considered.