Health Certificate

What a health certificate means

A health certificate (الشهادة الصحية) is a document that establishes a worker’s state of health in relation to a particular job. In Saudi Arabia the term is applied to more than one document, issued by more than one authority, and each document has a separate legal basis and a separate effect. Before anything is said about the conditions of a health certificate, it has to be clear which document is meant.

The distinction matters for an HR team because the documents do not substitute for one another. A certificate that satisfies one authority does not show that the requirements of another have been met, and a file that holds the wrong document can look complete while the examination the law actually requires has not taken place.

The documents called a health certificate in Saudi Arabia

• The occupational fitness certificate. It is the outcome of an examination carried out under the regulation on occupational fitness examinations and noncommunicable diseases (لائحة فحوصات اللياقة المهنية والأمراض غير المعدية), the fitness regulation for short, issued by the Ministry of Human Resources and Social Development under Ministerial Decision 33232 dated 11/3/1447H. The rules set out below concern this document.
• The municipal health certificate. It is the name in common use for the certificate required in occupations connected with public health. It is a document of a different authority, issued under a different system from the fitness regulation. In the sources we reviewed, we found neither the authority that issues it, nor its application channel, nor its conditions, nor its period of validity, so none of these is stated, and none of the rules below applies to it.
• The certificate of health fitness for a young person. Article 165 of the Saudi Labor Law (نظام العمل) requires the employer to obtain it before employing a young person, together with an identity document and the guardian’s consent, and to keep these documents in the young person’s file. The certificate has to meet two conditions: it must be issued by a specialist doctor and attested by a health authority, and one without the other does not meet the requirement. Royal Decree M/44 amended the Labor Law in 2025. That decree did not amend the provision on these documents, Article 165 of the Labor Law. The documents and the register that go with this case are set out in our guide to work prohibited for juveniles and the employment documents register.

Confusing these documents has a practical cost. An establishment that holds valid municipal certificates may not have completed the occupational fitness examination, and the reverse is equally possible.

The health certificate under the occupational fitness regulation and its guide

The fitness regulation has 21 Articles. It was published in the Umm Al Qura gazette on 2/5/1447H, corresponding to 24/10/2025.

Alongside it sits a procedural guide (الدليل الإجرائي), issued under Article 20 of the fitness regulation. The two are not interchangeable. The fitness regulation carries the retention periods, the confidentiality rule and the consequences of failing the examination, while the procedural guide carries the phased timetable and the operational detail. Each statement below is therefore attributed to the document it comes from.

Article 21 of the fitness regulation provides that it takes effect 180 days after its publication. Both the rule and the publication date are published. We found no calendar date for entry into force announced by the ministry, so none is given, and a date computed from the rule is not the same as a date the ministry has announced.

When a health certificate is required

• Before appointment. The procedural guide provides that a candidate may not start work before the result of the examination has been issued and approved through a doctor specialised in occupational medicine. It is therefore a condition that blocks the start of work, not a step that follows it, and its place in the process is within employee onboarding, before the first working day.
• Periodically. Under the procedural guide, the examinations are repeated every three years for all occupations classified as high risk, unless the competent occupational physician or the council (المجلس) to which the guide refers determines otherwise on the basis of the nature of the occupation and the assessment of risks. Periodic examinations are mandatory for those occupations. For other occupations the guide provides for examinations at regular intervals according to the nature of the occupation and the assessment and analysis of risks, and it gives no number. The three years are tied to one category, and applying them to every employee takes them outside that category. The classification of high risk occupations is referred to the council and to risk assessment, and in the sources we reviewed we found no list of those occupations, so the three year interval cannot be attached to a named occupation from the guide alone.
• On a triggering event. The procedural guide names an occupational injury or occupational disease that requires absence from work, a change of occupation, a change in the working environment, and retirement in cases of long exposure. Article 3 of the fitness regulation adds the return from long sick leave and the use of new equipment, machines or devices. The guide also requires the employer to request an exceptional examination where an accident occurs, where there is a noticeable change in performance or behaviour, where early signs of occupational or other diseases appear, or where similar cases are found among a number of workers.

Who the health certificate requirement covers

The procedural guide states its scope in wide terms. It applies to all workers in public bodies, private sector establishments and non profit organisations, whatever the type of contractual relationship or the nature of the work. It names permanent employees, workers on temporary or seasonal contracts, trainees, persons with disabilities and remote workers. It requires the examination to cover all categories of worker without exception, and among them it names workers supplied through service provider companies, workers on shift systems and workers on part time arrangements.

Article 18 of the fitness regulation applies the regulation to workers within the territory of the Kingdom and to those working in the Kingdom’s diplomatic and consular missions and official offices abroad. Article 18 of the fitness regulation does not extend the regulation to those who work outside the Kingdom for a Saudi establishment, unless the employment contract expressly subjects them to it. Under Article 3(2) of the fitness regulation, the regulation does not apply to medical examinations outside the scope of the job or occupation.

Article 4(2) of the fitness regulation requires the employer to provide the resources needed to carry out the examinations for its workers, and the procedural guide speaks of enabling the worker to undergo them. In the 21 Articles of the fitness regulation and in the procedural guide, we found no provision on who bears the cost, the fees or any reimbursement. The duty to provide resources is not a ruling on how the cost is shared, and it is not presented as one.

What a health certificate tells the employer

The confidentiality rule bears directly on HR practice. Article 17(4) of the fitness regulation prohibits the employer from viewing any medical details and confines the employer’s right to knowing the final occupational decision: fit, fit with restrictions or considerations, or unfit, without disclosure of the diagnosis or of the worker’s medical data.

The procedural guide extends the prohibition to administrative staff. Administrative employees who are not healthcare practitioners accredited by the Saudi Commission for Health Specialties may not view health records or medical reports.

The effect on the employee file is direct. What may be kept in the administrative file is the occupational decision alone, not the report, the test results or the diagnosis. An establishment that places a medical report in an administrative file puts in front of its HR staff what Article 17(4) of the fitness regulation forbids the employer to view, whatever the intention behind keeping it.

How long health certificate records are kept

Article 17(7) of the fitness regulation requires the body that holds the medical records to keep the occupational health record for at least ten years from the date of the last examination, or five years after the end of the employment relationship, whichever is longer. Where the worker has been exposed to substances or agents with a long latency period, such as asbestos or ionising radiation, Article 17(7) of the fitness regulation requires the record to be kept for at least thirty years after the work stops and until the worker reaches the age of seventy five.

The record must contain the medical notes, restrictions and recommendations, signed, dated and completed by the competent doctor. The procedural guide requires all results to be uploaded through the approved digital channels, and it provides that no step taken outside that system is recognised. These duties are addressed to the holder of the medical records, which is a separate role from the HR function that receives the occupational decision.

When the health certificate is not granted

• After a periodic examination. Under Article 13(2) of the fitness regulation, a worker who does not meet the fitness requirements after a periodic examination is barred from continuing to practise the occupation, and the supervising management must take the necessary steps to change the occupation, unless there is sufficient evidence, through additional examinations or recommendations set by a competent occupational physician, that the worker can perform the duties efficiently.
• Alternative work. Article 4(8) of the fitness regulation requires the employer to do what is needed to find alternative work where the worker’s job is medically prohibited, with flexible working hours, part time work or other arrangements, and a full reassessment before the return to the original job.
• Concealment. The procedural guide provides that the occupational fitness certificate is cancelled where information relating to the approved questionnaire is concealed, subject to Article 19 of the fitness regulation.
• Objection. The worker has thirty days to object. A committee decides the objection within fifteen days, and its decisions are binding unless challenged before the competent authorities.

Article 19 of the fitness regulation refers to the penalties and sanctions in the related laws, regulations and decisions. It carries no amount and no table, and in the sources we reviewed we found no schedule of penalties specific to the fitness regulation. For that reason we attach no fine to a missing health certificate.

Before relying on a health certificate

An HR team that asks for a health certificate first names the document it needs: the occupational fitness certificate, the municipal certificate, or the certificate for a young person. It then checks the requirement against the official source for that document, because the conditions of one do not carry over to the others.

This is an explanation of the concept and of the statutory provisions cited, not legal advice.