PurposeThis systematic review aims to examine integrating innovative work behavior through transformational leadership in the Saudi healthcare sector. A thorough literature research was carried out to address this problem.Design/methodology/approachA total of 50 papers reporting research on innovative work behavior, healthcare organizational performance and transformational leadership were included in the review.FindingsAs employees are motivated and developed, their innovative work behaviors are boosted, which improves organizational performance. It can be concluded that innovative work behavior and transformational leadership are correlated. The capacity of a healthcare company to create and execute benefits to the employees may assure service delivery efficiency in employees' performance.Practical implicationsThis systematic review will allow contemporary advancements, efficient health status monitoring and reliable solutions that aid optimal, equal and effective treatment in Saudi’s healthcare industry.Originality/valueIn an innovative workplace, workers may pitch fresh ideas to their management. Hence, employees see their employer as more transformational.