Background: Every year, over 2 million people gather together to observe the Hajj pilgrimage in Mecca. This presents a public health risk to both Saudi and the pilgrims’ country of origin. This study aimed to evaluate the risk perception and the source of health counseling by the pilgrims. Methods: a cross-sectional survey was conducted among internal and external pilgrims performing the Hajj. The survey evaluates the general safety and preventative measures applied, factors influencing public health safety at Hajj, source of pre-travel health counseling, recommended preventative health measures, and effective preventative measures. Results: A total of 233 pilgrims from 28 different countries completed the survey. The majority (94%) of the respondents considered the Hajj as safe while (88%) sought pretravel health counseling. The most popular source of pre-travel health advice among the pilgrims was from medical professionals (25.6%) and other pilgrims (18.9%). Diversity and carelessness were believed to be the main factors influencing public health safety during the Hajj by (79%) and (78%) of the respondents respectively. Yellow fever (50%) and wearing face masks (24%) were the most and least adopted recommended public health measures respectively while most pilgrims believed handwashing (59%) and wearing of face mask (51%) are the most effective preventative health measures. Conclusion: Our study shows a reduced perception by pilgrims of the health risks of the Hajj and highlights the need to improve how information is channeled to prospective pilgrims about preventative health measures. The discordance between recommended preventative health measures and adherence by pilgrims shows a need for a comprehensive enforcement program underpinned by the Saudi Ministry of Health (MoH).