Introduction: Although breastfeeding has been shown to have dual benefits for both infants and their mothers, the global rate of breastfeeding has been declining, especially in Middle Eastern countries. This decline necessitates an urgent exploration of the determinants of breastfeeding practices. Objectives: This study was conducted to evaluate the breastfeeding practices of Saudi mothers, compare them to the guidelines and recommendations of the World Health Organization and to examine the possible determinants of success in exclusive breastfeeding for the first six months of life. Methods: A quantitative observational cross-sectional study was conducted in 322 selected mothers of children between 6 months and 24 months of age who attended the well-baby clinic at King Saud University Medical City, Riyadh (2015). Results: Although 94.4% of the 322 Saudi mothers were successful in initiating breastfeeding on the first day of delivery, only 13.7% of all infants were exclusively breastfed at the age of 6 months. Factors predicting exclusive breastfeeding for the first six months of life in the study sample were previous experience with exclusive breastfeeding and the intention to exclusively breastfeed. In addition, the frequency of breastfeeding on demand at day and night was found to be significant. Sources of breastfeeding support are of great concern. Conclusion: The majority of Saudi mothers have suboptimal breastfeeding practices. A cohort study enrolling a larger number of exclusively breastfed infants is needed to gain a full understanding, as are actions to bridge the gap between current breastfeeding practices and the World Health Organization recommendations.