Loyalists of the extremist Islamic State group claimed responsibility for the attack -- the second against Shiites in the kingdom in six months.
In November, the extremist Islamic State group was accused of being behind the shooting and killing of eight worshippers in the eastern Saudi Arabian village of al-Ahsa.
Despite a string of IS-related attacks over the past many months that have also targeted police, today's suicide bombing appears to be the deadliest in the country in nearly a decade.
Saudi Arabia's Interior Ministry has not released its count for the number of dead and wounded, but said that a suicide bomber who hid explosives under his clothes was behind the attack.
Interior Ministry spokesman Maj Gen Mansour al-Turki said that the attacker struck the Imam Ali mosque in a village called al-Qudeeh.
In a statement distributed on Twitter feeds linked to IS group loyalists, a group purporting to be the IS branch in Saudi Arabia issued the claim.
The group's statement carried a logo in Arabic referring to itself as the "Najd Province" -- a reference to the historic region that is home to the capital Riyadh and the ruling Al Saud family, as well as the ultraconservative Wahhabi branch of Islam.
Mahmoud, the editor in Qatif, said the attacker stood with the worshippers during prayer and then detonated his suicide vest as people were leaving the mosque.
A local activist, Naseema al-Sada, told The Associated Press by telephone from Qatif that the suicide bomber attacked worshippers as they were commemorating the birth of Imam Hussain, a revered figure among Shiites.
The Al-Manar television channel, run by the Lebanese Shiite Hezbollah group, carried blurry pictures of pools of blood inside what appeared to be the mosque where the attack took place.
It also showed still photos of at least three bodies stretched out on carpets, covered with sheets. One person dressed in a white robe was being carried away on a stretcher.
The attack comes amid heightened Sunni-Shiite tensions in the region as Saudi Arabia and Iran back opposite sides in conflicts in Syria, Iraq and Yemen.
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