THIS STUDY aims at providing an overview and evaluation of the current situation of the national Diagnostic Reference Levels (DRLs) in Saudi Arabia. Studies published in Pubmed and Google-Scholar, since the DRLs were proposed, are reviewed and general considerations are highlighted, by reviewing some established international DRLs, regarding x-rays and nuclear medicine modalities. The importance of national DRLs (Saudi DRLs) is introduced and discussed. An overview of some studies on Saudi DRLs regarding selected procedures is presented and the validity of radiation dosimetry studies for establishing Saudi DRLs is discussed. The establishment of DRLs for pediatric patient procedures is introduced, discussed and emphasized. An enormous amount of work is required to establish the Saudi DRLs for different procedures, as more than 90% of the work has not been accomplished. Collaboration between researchers is necessary to allow comparisons of DRLs results and to validate the establishment of Saudi DRLs. Furthermore, DRLs for pediatric patient procedures should take priority.