Background: Severe asthma represents a minority of all asthma cases but contributes

disproportionately to morbidity , healthcare utilization and costs to society. Biological therapies target key inflammatory cytokines, receptors or immune cells that are driving eosinophilic activation and airway damage in the T2 inflammation cascade. This study aims to evaluate the evidence on effectiveness of biologics in Saudi Arabia. Study Objectives: The main objective of the research is to investigate the clinical effectiveness of biologic therapies, including dupilumab, benralizumab, and omalizumab, for the treatment of severe eosinophilic asthma in patients from Saudi Arabia, as well as the impact of the comorbidities of chronic rhinosinusitis and nasal polyps on treatment outcomes.  Materials and Methods: This is a narrative review using an exploratory research design where the data is gathered from various sources based on pre defined inclusion and exclusion criteria. The preferred Reporting Items for Systematic Review and Meta-Analysis PRISMA is used to segregate and screen the collected studies.   Results: The KSA population showed a robust efficacy in biologics: Asthma control improved in 91.8% to 92.8% of patients. OCS use was practically eliminated, improving from 77.3% (75/97) to 10.3% (10/97) (86.7% reduction). CS use was one of at least three measures of asthma control. The number of patients with one or more asthma exacerbations decreased from 84.5% pre-treatment to 14.4% post-treatment. Conclusion:  Local real-world evidence demonstrates a high level of effectiveness for these targeted agents; with more than 90% of patients who previously had poor control of asthma moved to either 'controlled' or 'partly controlled' status. The total clinical benefit is impressive, including an 83% reduction in the annualized rates of severe exacerbations and significant rates of oral corticosteroid treatment cessation, with a clear impact on long-term morbidity.