Primary health care, the basis of universal health coverage, needs to be assessed on its performance through Saudi health care quality system and future opportunities to serve the Saudi Arabian population increase the chance of desired health outcomes. Saudi Arabia has invested heavily in its health care system by establishing health care infrastructures to improve health of the nation. However, it remains to be seen whether it is efficient and effective in providing health care services needed. In spite of substantial improvements in the Saudi Arabian health services sector in the past few decades, the country is facing a number of challenges in its primary health care system. These challenges include increased demand because of rapid population growth, high costs of health care services, inequitable access, concerns about the quality and safety of care, a growing burden of chronic diseases, a less than effective electronic health system, poor cooperation and coordination between other sectors of care, and a highly centralized structure.