Background: Saudi Arabia embarked on transforming its primary health care system in 2016 to meet international standards, gain the people’s trust and respond to the growing burden of noncommunicable diseases, as proposed in the Saudi Vision 2030. Aims: This review aims to highlight the progress, identify challenges and prospects for Saudi Arabia’s PHC reform process in order to make recommendations to facilitate strengthening of the PHC system. Methods: A review of previous studies and governmental reports was undertaken to extract, analyse, synthesize and report the findings. Results: The review has indicated that by mid-2019, the reform has contributed to an increase of 37.5% in the rate of PHC visits and 4.7% increase in patient satisfaction, enhanced coverage of rural communities (from 78% to 83%), and contributed to increasing the screening rate for prevalent chronic diseases. However, the country still faces gaps and challenges pertaining to human resources issues, cultural and lifestyle behaviour, geography, intersectoral collaboration and PHC infrastructure. Conclusion: PHC reform process in Saudi Arabia has demonstrated that positive change is achievable. This has been aided by building on previous accomplishments and the wealth of experience gained throughout the PHC journey in Saudi Arabia. However, despite improvement in the quality of services, continuous improvement is required to meet the rising expectations of the population.