Background Hajj is a unique religious mass gathering among Muslims hosted by Kingdom of Saudi Arabia (KSA) annually. It is a fifth pillar that is compulsory to be carried among muslim. Infections due to Neisseria meningitides, Streptococcus Pneumonia and Influenza virus are very high among Hajj pilgrims in KSA. Severe diseases such as pneumonia, therefore pneumococcal vaccination is recommended. Pneumococcal vaccines are available and recommended in many countries for at-risk populations including young children, the elderly and those with underlying medical conditions. The Hajj and Umrah mass gatherings attract millions of Muslim pilgrims to the Kingdom of Saudi Arabia each year. These events increase the risk of pneumococcal disease especially among the large number of elderly pilgrims with co-morbidities. However, there is no unified official policy for vaccination against pneumococcal disease for pilgrims attending. Hajj and Umrah, largely due to the lack of a strong evidence-base in the context of these events. This study aimed: To assess the awareness and attitude toward prevention of pneumococcal infection and vaccination among Hajj and Umrah pilgrims Makkah Al-mukarramh Saudi Arabia 2022. Methods: A cross -sectional research design was carried out between Feb 2021 to May 2021 included 300 patients who were randomly selected from visiting to the primary health centers a structured questionnaire and observation checklist was used for data collection. Using 3 part Questionnaire and analyzed via SPSS v24 software. Chi-square test was run to analyses associations between socio-demographic data. Results: shows that most of the participants (37.0%) were in the age group >60 years follow by the (35.0%) were in the age 50-60 years, the majority of them were males (58.0%) while female (42.0%), Hajj for the first time (39.0%), has non chronic diseases (51.0%), follow by Renal failure were (35.%) Conclusion: There is a lack of knowledge among the hajj pilgrims about these vaccine preventable diseases and vaccination, especially those who have lower education level and also unemployed. pilgrims will be protected are highly advised to focus on these group and prepare a special course that focused on these vaccine preventable diseases so that Hajj pilgrims will be protected.