To identify the needs of families of adult intensive care unit (ICU) patients in Saudi Arabia as perceived by family members and health care providers. Background: Family members of critically ill patients are likely to have specific needs that should be addressed by the critical care team and which, if unmet, may produce stress for patients families and health care providers. The literature has yet to identify the needs of Muslim families in relation to religious beliefs and cultural values in critical care settings in Saudi Arabia. Design: A cross-sectional survey design. Method: A total of 176 family members and 497 intensive health care providers were recruited from eight adult mixed medical-surgical ICUs between November 2011 and February 2012 utilizing a four-point Likert type scale self-administered questionnaire. Results: The findings revealed that family members and health care providers ranked assurance, information and cultural and spiritual needs as the most important, and support and proximity as least important. There were significant differences in the mean values found between family members and health care providers. A significant finding not identified in other studies was The need to have the health care providers handle the body of the dead Muslim with extreme caution and respect which, under the dimension of cultural and spiritual needs, was perceived by family members to be the most important and by the health care providers as the fifth most important need. Conclusion: The recognition of family needs in the critical care unit informed the development of interventions to meet family needs and improve the care quality.