Introduction: The turnover of healthcare professionals is seen to be a significant contributor to the shortage of healthcare personnel. This study aimed to evaluate the level and predictors of retention intention among primary health workers (PHWs) in Buraidah, KSA. Methods: This cross-sectional study was conducted among primary healthcare workers in Buraidah, Qassim between the period from October 2023 to March 2024. Data were collected using an online self-administered questionnaire. The used scales in the study were the Job Autonomy Scale (JAS) and the Anticipated Turnover Scale (ATS). Data were analyzed using SPSS version 21.0. Results: A total of 194 healthcare workers were enrolled in this study; there were 50.5% males and 35.1% physicians. The mean ± SD of turnover intention was 37.2 ± 7.92 out of a maximum possible score of 75. The mean score of turnover intention was significantly affected by job title (p < 0.001), education level (p = 0.005), marital status (p = 0.004), attending certificate programs (p = 0.002), work method autonomy (p < 0.001), and total autonomy score (p = 0.008). Multivariate analysis revealed that the predictors of turnover intention were other job titles B 8.53 (95% CI: 6.17–10.89), ever married B –3.87 (95% CI: −5.80 to 1.94), and not attending certificate programs B –5.55 (95% CI: −8.46 to −2.63). Job autonomy did not show any association with turnover intention. Conclusion: Turnover intention was a significant problem among PHW in Buraidah, Saudi Arabia. The predictors of turnover intention included job title, marital status, and attending or having certificate programs. There is a need to address the issue of turnover intention among PHWs to ensure the provision of quality primary healthcare services to the population.