Background Saudi Arabia’s Vision 2030 aims for comprehensive healthcare coverage and workforce nationalization. However, physician distribution and composition disparities threaten these goals, affecting access and quality of healthcare services. Objectives This study examines physician-to-population ratios and workforce composition across 20 Saudi Arabian health regions, focusing on potential disparities. Methods A secondary analysis utilized the Ministry of Health’s 2022 Statistical Yearbook. Physician distribution and composition were explored using descriptive statistics, the Gini Coefficient, and a Lorenz curve. Results Findings reveal significant imbalances. While Riyadh, the capital region, hosts the largest physician count, its large population yields a lower physician-to-population ratio, reflecting significant service provision challenges. Al-Jouf and Northern regions exhibit higher ratios, indicating better balance. Non-Saudi physicians remain prominent, especially in Bishah and Najran, suggesting a need for stronger Saudization policies. Conclusion These findings underscore notable disparities in Saudi Arabia’s healthcare workforce distribution that can hinder Vision 2030 goals. Therefore, strategic interventions, including Saudization, educational reforms, regional healthcare clusters, and workforce development programs, are critical to aligning service demand with a sustainable supply of qualified professionals across all regions.