The World Health Organization recommends early initiation of breastfeeding (within 1 hour of giving birth). This study assessed the prevalence of timely initiation of breastfeeding by mothers of neonates in Al-Hassa province, Saudi Arabia. Mothers attending for birth registration at primary health care centres were interviewed and various sociodemographic, obstetric and health service related variables as well as breast problems were assessed for any influence on timely breastfeeding rates. While 91.9% of the 906 neonates studied were breastfed (8.1% were never breastfed), only 11.4% were given timely breastfeeding (within 1 hour after birth). Logistic regression revealed that the independent predictors of timely breastfeeding were: not giving prelacteal feed (OR 13.7), rural/hegar residence (OR 4.2), absence of breast problems (OR 3.4), parity 2 or 3 (OR 2.9) and parity 4+ (OR 2.4). Mothers at risk of delayed breastfeeding initiation should be the target of breastfeeding promotion during prenatal care.