Ottoman control over the Hijaz region, including the two Holy Cities, continued until the appearance of the first Saudi State in the eighteenth century. The new rulers in the middle of Arabia naturally aspired to take over both Makkah and Madinah, inspired by a combination of religious piety with the political calculation that such a move would bolster their ambitions. These two factors were inextricable, but the religious element was paramount because the political project was deeply infused with the strong faith and feelings of people who wanted to reform the beliefs and forms of worship around them. Both Muhammad bin Saud and Sheikh Muhammad bin Abdelwahhab longed to include Makkah and Madinah within their territories, but these aspirations had to wait for a future ruler from the same early Saudi State, Imam Saud bin Abdulaziz (1803-1814). In the early nineteenth century he entered both cities, one after the other.

The new gains did not last long for the entire Hijaz reverted to Ottoman rule; the final regaining of the region had to wait a few decades for King Abdulaziz (1902-1953). In the first quarter of the twentieth century Makkah, Madinah and all of the Hijaz came back under Saudi rule. Madinah was the last of the two Holy Cities to join the new state in 1925 with King Abdulaziz sending his son Muhammad to enact the transition. The following year King Abdulaziz visited Madinah, prayed in the Prophet's Mosque, and held a reception for the Madinah people. He spent two months in the Holy City rearranging its administrative and other affairs and reviewing people's needs. He appointed a governor to implement peace and order, Life went on despite the economic hardship that prevailed almost everywhere at the time.

Years later the economy improved considerably, mainly as a result of the discovery of oil and its export in commercial quantities. This was in 1945, the Second World War was coming to an end and the entire Saudi Arabia was witnessing the first stages of growth on all fronts, Foremost on King Abdulaziz's agenda was improving the condition of the Prophet's Mosque. The Mosque needed urgent repair but the King went beyond that to enlarge the size, thus allowing the increasing numbers of pilgrims and visitors to feel more comfortable.

King Abdulaziz's sons have ruled the Kingdom since their father passed away on November 9, 1953. In the reigns of Kings Saud, Faisal, Khalid, Fahad.