Background :Traditional and complementary medicine (TCM) is used by 75% of Saudi populations alongside conventional care, yet integration with preventive services remains unstructured. This systematic review assessed the effectiveness and safety of integrating TCM with conventional preventive healthcare for chronic disease prevention in Saudi Arabia.

Methods :MEDLINE, PubMed, Embase, Cochrane Central, and Scopus were searched (January 2000–July 2025) for studies in Saudi healthcare settings reporting on TCM integration, clinical outcomes, safety, patient satisfaction, or implementation strategies. Two reviewers independently screened and extracted data; quality was assessed using Cochrane RoB-2, ROBINS-I, and the Mixed Methods Appraisal Tool. Evidence certainty was rated with GRADE. Registration: PROSPERO CRD420251107697.

Results :Fifteen studies from 847 records included randomized controlled trials, observational, and implementation studies. TCM utilization ranged from 67–90%. Nigella sativa significantly improved HbA1c (0.8–1.2% reduction), systolic blood pressure (8–12 mmHg), and lipid profiles. Honey showed mixed glycemic effects but aided wound healing. Two pilot integrated clinics in governmental hospitals achieved >85% patient satisfaction. Barriers included provider knowledge gaps (39% poor CAM knowledge) and herb–drug interaction concerns. The National Center for Complementary and Alternative Medicine licenses five complementary practices with rigorous training. The Middle East CAM market was valued at USD 12.26 billion, with 22.77% annual growth. Evidence certainty was low to moderate due to limited high-quality trials.

Conclusion :High patient demand, cultural alignment, and regulatory support present strong potential for integrating TCM into preventive healthcare in Saudi Arabia. Expansion requires robust randomized trials, economic evaluations, and comprehensive provider education.

Keywords :Traditional medicine; complementary medicine; Saudi Arabia; preventive healthcare; chronic disease prevention