Objectives: To declare the medications onboard aircraft as a new initiative in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national medications onboard aircraft services guidelines. The projects formulated from the international business model, pharmacy project guidelines and project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase, the monitoring and controlling phase. Results: The medications onboard aircraft services with a defined vision, mission and goals. The services had various benefits including clinical and economic on patients as exemplified in the review. The continuous of the project assured by risk management model description. In addition, the monitoring and controlling of the services as declared. The transition to operation project though closing project stage discovered in the analysis. Conclusion: The medications onboard aircraft services is new initiative part of the medical and healthcare airlines program. The medications onboard aircraft properly meet the emergency need during aircraft journey and improve patient satisfaction on airlines healthcare and medical services; it is highly recommended to implement in Saudi Arabia.