Background: Episiotomy is the most common surgical incision in midwifery. It's important to study the frequency of episiotomy and its associated factors in women with spontaneous vaginal delivery SVD. Therefore, this study conducted to determine the prevalence of episiotomy and the affecting factors of performing episiotomy among delivering women in King Salman Armed Forces Hospital in Tabuk City, Saudi Arabia. Methods: This study is a descriptive “prospective” cross sectional design. Done among all women who are delivered with spontaneous vaginal delivery (SVD) in KSAFWRH labour and delivery ward. Results: Overall responders are 215 of total 300 research tools were analysed using SPSS 22 software. 132 the indication was prime parity, 66 were because of rigid perineum, while 63 were due to baby distress .The prime who had episiotomy due to prime parity were 132(91.06%), while the multi paras had episiotomy due to rigid perineum with 39(59.09%). There is a significant relation in the fetal distress and history of C/S and child birth attendance with most of the variables. Conclusion: The primary objectives of this study were to determine the prevalence of episiotomy and the affecting factors of performing episiotomy among delivering women. 300 research tool was distributed to midwifes to fill for each active vaginal delivery case, excluded 93 paper due to incomplete data. Within 207 complete research tools findings are showing 132 the indication was prime parity, 66 were because of rigid perineum, while 63 were due to baby distress .The prime who had episiotomy due to prime parity were 132(91.06%), while the multi paras had episiotomy due to rigid perineum with 39(59.09%). Chi- Square test was applied to calculate the p-value, there is a significant relation in the fetal distress and history of C/S and child birth attendance with most of the variables.