PurposeThree main objectives of this study were as follows: (1) To estimate the prevalence rate of post-traumatic stress disordered (PTSD) symptoms among Saudi paramedics, (2) To investigate which types of coping strategies were associated with PTSD symptoms among Saudi paramedics, (3) To explore which sources of social support were associated with PTSD symptoms among Saudi paramedics.Design/methodology/approachData were collected from 217 paramedics working in the Saudi Red Crescent Authority from September to December 2019. Participants completed questionnaires measuring PTSD symptoms (the Screen of Post-Traumatic Stress Disorders; SPTSD), passive and active coping strategies (Brief COPE Scale; BC), and three forms of social support: support from friends, family and organizational support. Associations between coping strategies, social support and PTSD symptoms were investigated using correlational analyses, hierarchical linear regression and binary logistic regression.Findings46% of participants experienced one or more PTSD symptom, 28.6% scored above the cut-off for partial PTSD and 17.5% scored above the cut-off for full PTSD. PTSD symptoms were significantly positively correlated with passive coping and negatively associated with both family and friends support. Passive coping was positively associated with a greater risk of meeting criteria for PTSD.Originality/valueThe current findings suggest that interventions to help reduce PTSD in Saudi paramedics should include strategies to reduce passive coping. Future research is urgently required to help understand the psychological, social and work-related factors that contribute to these high levels of PTSD.