The Internet of Medical Things (IoMT) has the potential to much improve healthcare services by means of better data availability and real-time monitoring. Still, security and privacy concerns are big obstacles to its adoption. This research investigates the factors affecting Saudi Arabian users’ behavioral intention to adoption IoMT systems with particular attention to privacy and security issues. Using the Unified Theory of Acceptance and Use of Technology (UTAUT), the study employs a quantitative method and analyzes survey data acquired from 191 respondents. The suggested model assesses how behavioral intent is impacted by performance expectancy, effort expectancy, social influence, security, privacy. The empirical results indicate that performance expectancy, effort expectancy, social influence, facilitating conditions, and security have a positive influence on the adoption of IoMT, while privacy has a major negative effect. High explanatory power allows the model to explain 43.6% of the variance in behavioral intention. Emphasizing the requirement of applying tight security precautions to resolve privacy issues and enhance trust in IoMT systems, the findings have significant practical consequences for Saudi Arabian healthcare decision-makers and technology innovators.