Background <p>Dermal filler injections represent one of the fastest-growing minimally invasive aesthetic procedures worldwide. In Saudi Arabia, demand for cosmetic interventions—particularly fillers—has surged, influenced by sociocultural, economic, and psychological factors. However, limited national data exist on how demographic characteristics and cosmetic surgery acceptance influence dermal filler intention and uptake.</p> Methods <p>A cross-sectional study was conducted among adults seeking or considering aesthetic procedures at a major dermatology and aesthetic center in Riyadh, Saudi Arabia (January–June 2025). Participants completed a validated questionnaire including demographics and the Acceptance of Cosmetic Surgery Scale (ACSS). Descriptive statistics summarized sociodemographic variables. Independent t-tests and ANOVA assessed differences in ACSS scores across demographic groups. Pearson/Spearman correlations and multivariable regression models examined predictors of acceptance and intention to undergo dermal fillers. Statistical significance was set at <i>p</i> &lt; 0.05.</p> Results <p>A total of 880 participants completed the survey, predominantly female (90.2%). Higher ACSS scores were significantly associated with age 40–59 years, female sex, Saudi nationality, higher monthly income, and being employed or retired (<i>p</i> &lt; 0.05). Regression analysis demonstrated that income, age, and ACSS ‘Consider’ subscale scores were the strongest predictors of willingness to undergo dermal fillers (<i>p</i> &lt; 0.05).</p> Conclusions <p>Positive attitudes toward dermal fillers were significantly influenced by demographic characteristics and ACSS scores, with intention to undergo fillers most strongly associated with income and middle-age status. Fillers are becoming socially normalized, particularly among financially independent women.</p> Level of Evidence <p>Not gradable</p>