OBJECTIVES: To explore the clinical and economic outcomes of clinical pharmacist at critical care units at private hospital in Riyadh city, Saudi Arabia METHODS:  It is a 6-months cross-sectional study from January to June 2016 in adults critical care unit at Dr. Alhabib Group Chain Hospitals. It is one of the biggest private chain hospitals in Kingdom of Saudi Arabia. It was a thirty-bed critical care bed consisted of trauma, medical, surgical and maternity critical care cases. The pharmacist monitored all patients through daily medical round and documents any pharmacist intervention. The pharmacist intervention system used an international study model (Kinky et al., Ann Pharmacother 1999), measure level of activity, rational of clinical intervention, recommendation, patient outcome and pharmacoEconomic impact. The estimated cost avoidance of prevents drug-related problems. RESULTS: The total number of pharmacist interventions were (1.222). Among pharmacist intervention 956 (78.2%) was Saudi and 266 (21.8%) was non-Saudi. The gender distribution 540 (44.2%) was female, and 682 (55.8%) was male. The majority of them in age 65 or older 459 (37.6%) and age (18-40) 368 (30.1%). The most drug classification had interventions was Anti-infective drug 363 (29.7%) followed by musculoskeletal and joint disease medications 199 (16.3%). The highest interventions were potentially significant 610 (49.9%) and potentially serious 360 (29.5%). The most rationale of intervention was inappropriate dose 245 (20%), and therapeutic duplications (11.3%). The most patient outcome was unknown 539 (44.1%), patient condition improved 408 (33.4%), and therapeutic end point reached 133 (10.9%). The most pharmacoEconomic impact was the reduction in cost drug therapy 884 (72.3%). The estimated cost avoidance (220,882.1 USD), the total annual estimated cost avoidance (441,764.2 USD) CONCLUSIONS: The clinical pharmacist at critical care units of the private hospital is crucial and essential. The pharmacist prevent drug-related problems and saving additional cost of pharmacy services and health insurance system