No data are available on primary spontaneous pneumothorax (PSP) in Arabs. Hence we sought to determine its characteristics in Arabs of the Al-Ahmadi Governorate in Kuwait. All patients over 10 years of age with pneumothorax who were admitted to the only free general hospital serving Ahmadi area from 1985 to 1996 were reviewed retrospectively. The study included all patients' medical records, investigations, treatment, morbidity, and mortality. Any patient with secondary pneumothorax was excluded. Primary spontaneous pneumothorax was rare in female Arabs, as they are almost never smokers. There were only two females out of total 58 patients with an incidence of 0.3 per 100,000 per year. Its incidence in male Arabs was 8.8 per 100,000 per year, similar to that in other studies. The distribution had a monophasic pattern, the average age being 23 (± 7.3 SD) years at the first episode. Smoking, a tall, asthenic (slim, relatively weak in appearance, ectomorphic) body build, and a positive family history are the most important risk factors and are not different from most studies conducted in other parts of the world.