Objectives: To explore the mass gathering hajj emergency pharmacy as new initiatives in the Kingdom of Saudi Arabia. Methods: It is a new initiative project drove by national mass gathering pharmaceutical programs. The projects drove the mass gathering medicine guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The mass gathering emergency pharmacy services with a defined vision, mission and goals. The services had various benefits, including clinical and economical on pilgrims, as described in the review. The continuity of the project assured by the risk management model description. Moreover, the monitoring and controlling of the services as demonstrated. The transition to operation project though closing project stage exemplified in the analysis. Conclusion: The mass gathering emergency pharmacy is a new initiative project in the mass gathering medicine. There are various emergency pharmacy services can be started during the mass gathering with clinical emergency pharmacy; it is highly suggested in Saudi Arabia.