Background: Modern nursing in Saudi Arabia is acomplex issue in which cultural diversity presentsthe major challenge to the evolution of Saudinursing as an independent indigenous professionalworkforce. Historically, patients and the nursesin Saudi Arabia come from different linguisticand cultural backgrounds with the reliance on apredominantly foreign nursing workforce, resultingin culturally based conflicts.Aim: This report opens a window into Saudi Arabiannursing practice in action for international readers,through which the complexities of the problemsfrom a Saudi standpoint are presented.Discussion: Literature shows misunderstandingsand conflicts with patients through the lack ofcultural skills in how to interact with them in aculturally appropriate manner which can give riseto conflicts and tensions. These can endangerpatient care and increase the risk of errors, theconsequences of which could prove fatal.Recommendation: Care should be taken duringthe processes of recruitment and orientatingforeign nurses practising in Saudi Arabia. Culturalsensitivity of the nursing cultural requirementsneeds to be enhanced by the development ofeducational protocols for cultural competency forall nurses.Conclusion: The distinctiveness of the culture ofthe Saudi Arabians and the control by foreignerswith scant knowledge about their culture, heightensthe challenges of providing nursing care that isculturally proficient. Nurses should understand andacknowledge variations that define patients fromdifferent cultural settings. If nurses have a goodgrasp of the cultural attributes of their clients, thenthey are well placed in caring for them.