This study examines patient-perceived healthcare quality in Saudi Arabia through a comprehensive analysis of experiences, expectations, and outcomes across the Kingdom's evolving healthcare landscape. Drawing upon Donabedian's structure-process-outcome framework, we synthesize current research to identify key factors shaping how Saudi patients evaluate healthcare quality. Findings reveal that while substantial investments have improved structural aspects of care, patients continue to report challenges related to communication, waiting times, care coordination, and service integration. Patient perceptions vary significantly based on sociodemographic factors, health status, care complexity, and healthcare setting, with notable disparities between citizen and non-citizen experiences. Cultural influences—including family-centered decision-making, gender considerations, and religious values—profoundly shape quality expectations, while rising education levels and international exposure are driving evolving standards. The analysis highlights promising improvement strategies at system, provider, and policy levels, including workforce development, communication enhancement, person-centered care implementation, and regulatory reforms. As Saudi Arabia pursues its ambitious healthcare transformation, centering patient perspectives on quality will be essential for achieving a system that delivers not only technically excellent care but also meets the diverse needs, preferences, and expectations of its population. Future research priorities include longitudinal studies, vulnerable population investigations, implementation science, and technology impact assessments.