Background: Nurse-patient communication is a unique clinical skill in the healthcare professions that promotes good quality care and patient outcomes. This communication can be disrupted by many barriers that impact the therapeutic relationship and deliver of care. Purpose: The study aims to identify the barriers affecting nurse-patient communication at primary health centers in Almadina Munawara City, Saudi Arabia. Methods: A cross-sectional study was performed among 212 nurses and 214 patients utilizing a self-reporting questionnaire. A version of the same file was then uploaded into NVivo, and data that were coded under all communication barriers including language discordance among patients and healthcare providers (e. g., subtheme: patient prefers a mother tongue speaking doctor), cultural-religious difference and environmental cues between the involved parties to determine their importance in this context as well (see Table 2). Results: The results showed that language, cultural and environmental differences had an extensive influence on how nurses communicated with patients. Key barriers included nurse shortages, limited communication time and low income. Our results suggest that these barriers differ in their effect with language barrier and habitat disturbance being the most important ones. Conclusions: This study concludes that nurse-patient communication is a complex multi-sectional process, constrained by numerous barriers. Strategic intervention aimed at addressing these barriers can strengthen nurse-patient interaction and accelerate patient care. Communication remains a cornerstone in all the best practices of delivering healthcare effectively and keeping patients happy.