A positive attitude to organ donation among doctors is key to increasing organ donation. Education of medical students is suggested to be central to achieving this. This study examined whether knowledge of organ donation and transplantation (ODT) correlates with attitudes and beliefs relevant to ODT among medical students in Saudi Arabia. Two hundred and thirty-three students completed a self-administered questionnaire. A knowledge score was calculated for each student and correlated with answers on attitudes and beliefs with regard to ODT. This study revealed a complex interaction between knowledge, attitudes, and beliefs to ODT. The majority of students support ODT in general, but a significant proportion have negative beliefs when asked about specific details of the process and concern for family members with regard to both deceased and live donation is evident. Despite almost all students believing that Islamic beliefs do not preclude ODT, 27.1% believe transplantation to be unacceptable in the Society in which they live. Education is an important strategy to improve donation rates. These findings can guide development of medical student education programs suggesting inclusion of open debate about views in society and the importance of discussion with family members to be essential.