Objectives: To explore the national survey of clinical pharmacy practice in Saudi Arabia from 2017- 2018 with an emphasis on performances and activities. Methods: This is a 4-month cross-sectional national survey regarding clinical pharmacy practice in Saudi Arabia. The study consisted of two parts: The first part collected demographic information and the second part comprised a questionnaire with 51 questions divided into four domains. The questions were derived from the standards of the American Society of Health-System Pharmacists (ASHP) and Saudi Pharmaceutical Society (SPS) survey, the international standards of the Joint Commission of Hospital Accreditation, in addition to the local standards of Saudi Center of Healthcare Accreditation. The four domains were as follows: clinical pharmacy administration and management, performances and activities, education and training and workload documentation. The responses were obtained using a 5-point Likert response scale system with close- and open-ended questions. The survey questionnaire was distributed in an electronic format to the 31 directors of pharmacies at various hospitals in Saudi Arabia. In this study, we analyzed the national survey of clinical pharmacy practice at hospitals in Saudi Arabia with regard to performances and activities. All data were obtained through the Survey Monkey system. Results: The survey questionnaire was distributed to 31 hospitals. Majority of the specifications of clinical pharmacy services provided were for concurrent and routine monitoring of drug therapy of the patients (17 (54.84%)) and written medication history (16 (51.61%)). Majority of the clinical services recorded was for answering drug information inquiries (74.19%), error and adverse drug event reporting (70.97%) and medication administration (70.97%). Most of the pharmacy units had clinical pharmacy services for control and narcotics system (4.13 (82.60%)), unit dose system (4.07 (81.40%)) and adults emergency medication (3.45 (69%)). Most of the hospital programs had clinical services existed for stewardship antimicrobial (64.52%), medication safety (61.29%) and medication reconciliation/history-taking (54.84%). Most of the methods of clinical pharmacist prescribing privileges in relevant hospital programs was prescribing under physician supervision (66), followed by independent prescribing (49) and refill prescribing (20). Conclusion: The performances of clinical pharmacy services monitoring of drug therapy only; that is including medication misadventures monitoring and prevention through antibiotics, medication safetyrelated services. The clinical pharmacist had inadequate prescribing privilege under physician supervision. Targeting of upgrading the clinical pharmacy performances and privilege is higher recommended with New Saudi vision 2030 to improve patient clinical outcome and avoid any economic burden of the healthcare system in Saudi Arabia.