Results: A total of 430 confirmed CF patients, 49.54% patients are males, and 50.46% are females. Around 94% were of consanguineous marriages, 45% had family history of CF. Multiple chronic complications have been encountered in the care of this group: (11%) of patients were confirmed to have Meconium Ileus, (3%) revealed to have a gall bladder stones, 2 patients required cholecystectomy. Pancreatitis was found in (2%). (56%) had elevated liver enzymes:  AST in (36%), elevated alkaline phosphatase (ALP) in (49.1%), elevated GGT in (23%), and elevated bilirubin in (7%). (12%) have Diabetes mellitus that detected as early as 3 years of age. (72%) who had first sample Vit A level measured were Vit A deficient. (81%) patients had vitamin D deficiency. (31%) had Vit E deficiency. (23%) had Vit K deficiency. Follow up samples of ADEK vitamins showed persistence of deficiency between 36 - 81% despite supplementation for 4 - 7 years’ period. There is a persistent increase in the prevalence of the common bacteria over the follow-up period of 7 years, namely Hemophilus influenzae (H. influenzae), Staphylococcus aureus (S. aureus), and all Pseudomonas (P. aeruginosa) culture types. Comparing cultures from the first and last follow-up visits, there was an increase in the prevalence of all (P. aeruginosa) cultures from (34%) to (53%), and a decrease in the prevalence of (S. aureus) and (H. influenzae) during the same follow-up period. (11%) were positive for MRSA,

Conclusion: CF is a common disease in Saudi Arabia. Chronic complications of the disease required multiple disciplinary team and affected their median survival.