Introduction: The landscape of heart transplantation in Saudi Arabia has witnessed significant changes since its inception in 1986. This historical review aims to highlight the trends, progress, and utilization of hearts for valve transplantation in the country, without focusing on specific transplant centers.

Methods: A retrospective analysis of heart transplantation data in Saudi Arabia was conducted to assess the evolution of transplantation activities and the utilization of hearts for valve transplantation. Data on transplanted whole hearts, heart-for-valves transplantations, collected heart valves, and the reasons for valve discard were examined.

Results: Since 1986, a total of 566 whole hearts have been transplanted in Saudi Arabia, demonstrating consistent progress with a steady growth. The 2000’s saw a noticeable increased in heart transplant activity, reflecting advancements in the field. Additionally, 758 heart-for-valves transplantations have been performed. In terms of heart valve transplantation, a total of 15 hearts were collected specifically for this purpose.

Conclusion: The historical growth in heart transplantation and heart valves transplantation in Saudi Arabia showcases the dedication and proficiency of the nation's medical community in providing hope to heart transplant recipients. However, optimization of donated heart valve utilization is essential to ensure these valuable resources can be used to save and improve lives. Continued efforts in addressing the challenges related to heart valve transplantation and improving the overall transplantation process are needed to maximize the impact of these life-saving initiatives.