Telemedicine has become a vital part of healthcare transformation in Saudi Arabia, driven by rapid technological progress, national digital health strategies, and the need to improve access to patient-centered care. This paper provides a detailed narrative review of telemedicine in the Kingdom, exploring its current uses, enabling technologies, main challenges, and future strategic directions. Using the World Health Organization (WHO) digital health classification framework, the review maps key Saudi telehealth applications across interventions for patients, healthcare providers, health system management, and data services. The results show significant progress in teleconsultation, appointment management, public health surveillance, and tele-pharmacy, mainly supported by government-led platforms and Vision 2030 initiatives. However, ongoing barriers such as regulatory fragmentation, data privacy issues, digital literacy gaps, infrastructure disparities, and limited integration of advanced analytics continue to restrict widespread and effective adoption. Looking ahead, the paper highlights strategic priorities for advancing telemedicine in Saudi Arabia, such as strengthening governance and interoperability, expanding intelligent and data-driven services through artificial intelligence and connected technologies, improving digital capacity building, and ensuring equitable access across regions. Overall, the review provides policy-relevant insights to support the sustainable integration of telemedicine into Saudi Arabia’s healthcare system, aligned with Vision 2030 goals.
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