Objective: To examine the frequency of pain-related TMD in Saudi Arabians 20 to 40years old referred to a d specialist clinic in Makka. Materials and Methods: 325 referred patients (135 males, 190 females) filled in history questionnaires. Patients reporting pain-related TMD were clinically examined. The history and clinical examinations were performed according to an Arabic version of RDC/TMD Axis I and Axis II (Dworkin et al 1992). Results: All patients had a male-female ratio of 1:1.4. TMD pain patients were found to be 18% (n=58), out of which 46 were clinically examined. The 46 TMD pain patients had a mean age of 30 years (±7) with a male-female ratio of 1:6. All TMD pain patients had a diagnosis of myofascial pain and 66% had diagnoses of arthrogenous origin. The graded chronic pain was reported to be grade I in 45%, grade II in 53%. Axis II assessment of psychological status showed that 38% of the TMD pain patients yielded severe depression scores and 60% high nonspecific physical symptom scores. Conclusion: The present study showed a high frequency of TMD pain in this Saudi Arabian cohort and 18% of the patients met criteria for subdiagnoses of TMD. Depression and somatization according to SCL-90R had significantly higher scores in the pain group compared to the non-pain group. The high frequency of pain-related TMD found among the patients referred to specialized dental clinics should make health planners considering TMD/orofacial pain as specialty in dentistry in Saudi Arabia.