Background: A number of studies have highlighted the physical health problems associated with adolescent pregnancy in Saudi Arabia , However there were few studies dealing with the postpartum psychiatric disorders .The study aims to determine the prevalence of postpartum psychological distress and to evaluate the associated risk factors in a sample of primigravid young women in Al Ahsa region, Saudi Arabia. Methods: We assessed the prevalence of postnatal mental health in 190 young mothers attending the maternity hospital using general health questionnaire. We also assessed the relationship between socio-demographic, psychiatric and obstetric risk factors and the mental health. Results: The percent of women with psychological distress was 35.2%. Significant risk of psychological distress was associated with several socio-demographic, psychiatric and obstetric risk factors. Only four items were found to be significant predictors of postpartum psychological distress; low family income, poor husband support, birth of female baby and gestational diabetes. Conclusions: These results highlighted importance of screening for psychological distress and its associated risk factors in the implementation of proper perinatal care for the pregnant Saudi adolescents.