The pharmaceutical supply chain represents a critical component of healthcare delivery systems worldwide, yet significant challenges persist in specialized care settings such as long-term care facilities and maternity hospitals. This review examines the current state of pharmaceutical supply chain management in Saudi Arabia, with particular emphasis on logistical challenges affecting long-term care and maternity care settings. Through systematic analysis of recent literature and empirical evidence, this study identifies key operational barriers including medication shortages, inventory management deficiencies, cold chain disruptions, inadequate demand forecasting mechanisms, and infrastructure limitations. The Saudi healthcare system faces unique challenges stemming from high dependency on pharmaceutical imports, centralized procurement complexities, and the requirements of Vision 2030 healthcare transformation initiatives. This review synthesizes evidence on supply chain optimization strategies including technological innovations, improved forecasting models, enhanced cold chain management protocols, and resilience-building measures. Findings indicate that integrated approaches combining advanced information systems, collaborative stakeholder engagement, and adaptive inventory management significantly improve pharmaceutical availability and reduce operational costs. The study contributes to healthcare supply chain literature by providing a comprehensive analysis specific to Saudi Arabian long-term and maternity care contexts, offering evidence-based recommendations for policymakers and healthcare administrators seeking to enhance pharmaceutical logistics performance in specialized care environments.