Many countries in the Middle East struggle to combat environmental problems such as air pollution, poor water quality, overflowing garbage, and more. Yet little is known about how people in the region perceive these problems and the factors that influence their perceptions. This study examines the findings from surveys conducted by the Arab Barometer with 13,850 people across 12 Middle Eastern countries in 2018-19. The focus is on public perceptions about water pollution, air quality, and trash. About 91 percent of respondents said that water pollution is a very serious or serious problem. About 89 percent and 73 percent feel the same way about trash and air quality, respectively. Middle Easterners’ perceptions about environmental quality are mainly shaped by their educational background, current financial status, and level of support for democratic politics. Objective measurements of water quality and sanitation are directly linked to people’s perceptions: all else equal, countries with better water and waste management have populations that are less concerned about these issues. Yet in the case of air quality, objective measurements are divorced from people’s perceptions. Instead, a person’s age, gender, education level, minority status, and their political and economic attitudes are better predictors of the extent to which they perceive air quality to be a problem. These findings shed light on the topic of environmental concern in an understudied region, highlighting the ways that individual, local, and national factors shape how average people evaluate local environmental problems.