Background/Objectives: Social media popularity and shifting cultural standards of beauty have intensified the growing demand for cosmetic procedures in Saudi Arabia, and body dysmorphic disorder (BDD) has not previously been given due consideration in cosmetic surgery-seeking behavior. This study determined the proportion of females screening positive for BDD and identified its predictors. Participants and methods: The present study employed an analytical cross-sectional design and was conducted from January 2025 to July 2025 in the Dammam region (Eastern) of Saudi Arabia. A validated tool was utilized to assess sociodemographic characteristics, cosmetic surgery history and intentions, social media exposure, and BDD symptoms. We applied a multivariate analysis to identify the predictors. Results: Among the 250 participants, 72 (28.8%) screened positive for BDD. The positive screening for BDD was significantly higher among the participants with a qualification of university and above (ref: up to high school, AOR = 1.291, 95% CI = 1.016–1.667, p = 0.038), who considered cosmetic surgery during their current visit (ref: no, AOR = 3.123, 95% CI = 1.671–4.982, p = 0.001), and more than 3 h use of social media (ref: less than 1 h, AOR = 4.368, 95% CI = 3.570–5.134, p = 0.007). Conclusions: The present findings suggest that a BDD screening program and a multidisciplinary approach are required to ensure ethical practice and to decrease the repeated or unnecessary interventions. Furthermore, future multicenter and mixed-method studies should be conducted to confirm these findings and guide national psychological assessment practices in aesthetic medicine.