Abstract
Background and Aims:
The use of anabolic-androgenic steroids among athletes and gym users is still prevalent despite the enforcement of regulations and penalties. The hormones are used to enhance muscle mass and performance, but frequent use is associated with various side effects. The objectives of this research were to study the prevalence, use, and level of knowledge of gym users on AAS.

Methods:
The study design was ross-sectional. The sample size was 152, including males who used the gym in the last six months. The data was collected by a pre-tested questionnaire after obtaining ethics approval. The SPSS software was employed for data analysis. The chi-square test was used to compare the qualitative data and a p-value of less than 0.05 was considered significant.

Results:
The age of most (85.5%) gym users was between 20 and 40 years, and the education level of most of them was university (84.2%). The prevalence of AAS use was 13.2%. The level of knowledge of 62.5% of the AAS users was poor. The advice to use was mostly provided by the gym coaches (75%). The occupation showed a significant relationship with the level of knowledge, the students have the highest level (42.9%) of AAS adequate knowledge.

Conclusions:
The prevalence of the use of AAS in Majmaah, Saudi Arabia is moderate. The level of knowledge of AAS among the Gym users is inadequate. The students are the most knowledgeable about AAS. The advice to use AAS is commonly from the Gym coaches.

Key words: Prevalence, awareness, Anabolic-androgenic steroids