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Intranasal corticosteroids (INCS) are generally safe and effective treatments for allergic rhinitis (AR). The improper use of INCS may not alleviate AR symptoms, and it could lead to complications and an impaired quality of life. We evaluated the knowledge of, attitudes towards, and practices of INCS usage and associated factors among AR patients using a pretested Arabic questionnaire. Of the 400 participating AR patients, 39.3%, 29.0%, and 36.5% had poor scores for knowledge, attitude, and practice, respectively. We found a significant association between knowledge and education (<i>p</i> < 0.001) and follow-up facilities (<i>p</i> = 0.036). The attitude category was significantly associated with age (<i>p</i> = 0.003), marital status (<i>p</i> = 0.004), and type of allergic patients (<i>p</i> < 0.001), and the practice category was significantly associated with education (<i>p</i> = 0.027), type of allergic patients (<i>p</i> = 0.008), and follow-up facilities (<i>p</i> = 0.030). Smoking status was significantly associated with all three categories. Furthermore, we found a positive correlation between knowledge and practice scores (Spearman’s rho of 0.451, <i>p</i> < 0.001). We recommend improving AR patients’ knowledge of the proper practices of INCS through health education programs. Furthermore, we recommend an exploratory mixed-method survey on the INCS usage among AR patients that involves other provinces in the KSA.