Background: Saudi Arabia’s health sector is undergoing substantial reform under Vision 2030, including expansion of insurance-based financing and private-sector participation. Evidence on the factors that shape patients’ choice between public and private hospitals in Jeddah remains limited. Objective: To identify demographic, socioeconomic, service, efficiency, and treatment-cost factors associated with patients’ choice of public versus private hospitals in Jeddah. Methods: A quantitative cross-sectional study was conducted among adults aged 18 years or older who had used a public or private hospital in Jeddah within the preceding 12 months. Data were collected using a structured online questionnaire adapted from a prior Saudi study. Of 429 respondents, 400 complete responses were analyzed. The final multi-item scales showed acceptable internal consistency (Cronbach’s alpha: services/facilities 0.878; efficiency/staff performance 0.823; treatment cost 0.729). Chi-square tests, independent-samples t tests, and binary logistic regression were performed in SPSS version 27. Results: Private hospitals were used by 69.0% of respondents. Hospital choice was associated in bivariate analysis with age, gender, nationality, employment status, health insurance, and family size. Public-hospital users reported higher mean service/facility and efficiency scores, whereas private-hospital users reported higher treatment-cost scores. In the adjusted model, these perception scales were not independent predictors. Health insurance strongly increased the likelihood of private-hospital use (OR=6.269, 95% CI 3.140-12.517; p<0.001). Income of at least SR 20,000 was also associated with private-hospital use (OR=6.722, 95% CI 1.072-42.140; p=0.042), while government employment (OR=0.147; p=0.002) and family size of 12 or more (OR=0.103; p=0.004) reduced the likelihood. Conclusion: Hospital choice in Jeddah appears to be driven more by structural enabling resources particularly insurance, income, employment-related access, and household size than by subjective perceptions of service quality, efficiency, or treatment cost after adjustment.