Objective: The aim of this study is to explore pharmacists’ attitudes regarding pharmaceutical care in chronic kidney disease (CKD) and end‑stage renal disease (ESRD) patients. Methods: A cross‑sectional questionnaire‑based study was conducted among Saudi pharmacists between October 2012 and October 2014. A convenient sampling technique was employed in the five Saudi Kingdom regions: Central, West, East, North, and South. The target sample was 200 pharmacists based on a calculation of the power of sample with an 85% confidence level. SPSS, version 20®, was used to descriptively analyze the data. The Kruskal–Wallis test was applied to highlight the significant responses. A P < 0.05 was considered statistically significant. Results: Of the 200 questionnaires distributed, 162 were completed; a response rate 81.0%. Based on the results, pharmacists in Saudi generally had positive attitudes and beliefs toward pharmaceutical care in CKD and ESRD due to a complicated disease state with multiple drug and nondrug therapies (69.1%); this finding indicated that this type of pharmaceutical care requires that more time is dedicated to patients (69.7%). The results showed that 40.8% of pharmacists were familiar with National Kidney Foundation‑Kidney Disease Outcomes Quality Initiative clinical practice guidelines. Most pharmacists either agreed or strongly agreed that implementing this type of pharmaceutical care will have a positive economic impact on patients’ families and the health system. The physician–pharmacist relationship is also considered to be a major barrier for pharmacist intervention given that physicians have primary responsibility for modifying the patients’ treatment plans. Conclusion: The contribution of pharmacists in CKD and ESRD will continue to grow as their clinical knowledge improves. Saudi pharmacists believe that the pharmaceutical care is an essential component of managing CKD and ESRD patients.