Precision medicine (PM) is the systematic approach to healthcare based on specific genetic, environmental, and lifestyle characteristics and revolutionizes the process of disease prevention, diagnosis, and treatment. The development of PM in Saudi Arabia has progressed as part of Vision 2030, such as the Saudi Genome Program mapping population genomics to make personalized care possible. This is a full literature review covering 2020-2025 on PM uses, whether it is genomic screening (e.g., newborn programs to diagnose rare diseases) or individualized protocols (e.g., pharmacogenomics to reduce adverse drug reactions by 30-50%). Based on 45 studies, it has been found that the market is growing (USD 215 million in 2023, with a 12.5% CAGR), with better results in chronic diseases (e.g., managing diabetes through AI-genomics), yet there are obstacles such as inadequate infrastructure, data privacy concerns, and urban-rural differences (only 29.6% of clinicians are highly knowledgeable). The main projects are summarized in tables, the market trends, the level of awareness, and improvements of outcomes are shown in graphs. The discussion and critiques are based on biases to cities and a lack of longitudinal data, and the recommendations are based on the policy roadmap, biobank, and interdisciplinary education. The integration of PM will offer fair healthcare, which is consistent with HSTP towards fewer burdens caused by consanguinity-related disorders (prevalence 57%).