Saudi Arabia is enlarging its pharmaceutical and biotechnology base as part of a wider retreat from import dependence. For advanced drug-delivery products, however, adding capacity is not the same as adding capability. Performance in these products is governed by particle size, polymer microstructure, mixing history, sterile handling, device geometry, release kinetics and analytical control, and these variables prove stubbornly difficult to reproduce once a manufacturing site changes. This review examines how technology transfer and process scale-up must be combined if advanced drug-delivery manufacture is to take root in the Kingdom, covering modified-release oral products, hot-melt-extruded systems, lipid and polymeric nanoparticles, long-acting injectables, microneedle platforms and digitally manufactured dosage forms. A structured narrative method was used to assemble peer-reviewed evidence published between 2020 and 2025 together with the quality frameworks issued in that period. The Kingdom's starting position is quantified rather than asserted: analysis of the Saudi Food and Drug Authority formulary shows that 22.55% of registered items are manufactured domestically against 43.86% originating in Europe, that four producers account for 63% of domestic output, and that approximately 86% of surveyed national manufacturers cannot at present enable nanotechnology-based medicines even though more than 93% regard such products as important. Against this baseline the review argues that localization should be treated as a capability-transfer programme rather than an equipment-purchase exercise, requiring a product-specific knowledge package covering critical material attributes, critical process parameters, critical quality attributes, analytical procedures, process models and change-control logic. A phased pathway is proposed in which secondary operations and sterile fill-and-finish establish a learning base, followed by formulation ownership, platform manufacturing, advanced process control and regional export.