<b><i>Introduction:</i></b> Trauma is one of the leading causes of morbidity and mortality in Saudi Arabia (SA) and worldwide and remains the leading cause of mortality in younger people. We conducted a literature review to assess the current trauma system in SA and formulated an action plan that might help guide leaders and colleagues in implementing a mature trauma system across the country. <b><i>Methods:</i></b> We searched PubMed, ScienceDirect, publications from the World Health Organization (WHO), and American College of Surgeons (ACS) and formal reports from the ministries and authorities in SA. <b><i>Results:</i></b> After aligning the trauma care system in SA to the WHO trauma system maturity index (TSMI) and ACS criteria for a mature system, the SA system was found to have many deficiencies in essential components such as national trauma registry or active trauma research activities. Injury prevention and prehospital care are progressing and may be graded as TSMI level III, indicating room for improvement. Regarding the definitive care at hospitals and centers, only 2 centers at Riyadh met the criteria for level I trauma centers. Other regions in SA do not have major trauma centers yet. Overall, the components of the SA trauma care system were graded from levels I to III on the basis of the WHO TSMI and ACS criteria for a mature trauma system. <b><i>Conclusion:</i></b> In SA, injury remains the primary cause of death in children and other younger people. Efforts to reduce the prevalence and burden of trauma in SA are progressing. Completion of a nationwide trauma system would be a major step toward achieving that goal. We have proposed an action plan to achieve that goal.
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