Objective: To evaluate the health education infographics posted on Twitter accounts by major health care institutions in Saudi Arabia. Method: Cross-sectional review of health education infographics using a semi-structured evaluation form. The scoring rubric included 10 criteria grouped under 4 main headings: (1) usefulness, (2) legibility, (3) graphics and illustrations and (4) aesthetics. Rated on a scale of 1 to 5, scored items were summed and converted into a percentage. Each infographic was classified as being of high quality (70%-100%), medium quality (40%-69%) or low quality (0%-39%). Results: A total of 297 infographics were evaluated. The most common topics concerned chronic diseases and associated risk factors (n = 72) and healthy lifestyle (n = 51). The highest re-tweets (524), likes (605) and replies (226) were received by government organisations. Overall, 249 (83.8%) infographics were categorised as of 'high quality', 46 (15.5%) as 'medium quality', and 2 (0.7%) as 'low quality'. The highest proportion (93%) of 'high-quality' infographics came from government hospitals. Among individual criterion, drawings (17.2%) made up the highest proportion of the 'low quality' category followed by overall design (10.8%) and purpose (10.8%). Light text (covering < 50% of the infographic) showed a significant statistical association with the number of replies (p = 0.007), number of likes (p = 0.003) and number of retweets (p = 0.018). Conclusion: The majority of infographics were rated as being of 'high quality'. Government institutions were assessed as having better quality infographics than private hospitals. We recommend that social media design specialists and health education specialists collaborate to design clear infographics with better overall design.