Al-Adan hospital intensive care unit was established since 1983 with 10 beds covering medical and surgical patients. Today the unit expanded to 46 beds to accommodate the expanded population of 1.2 million making it the largest in the country. It covers all specialties including surgical, medical, obstetric, trauma, neuro and cardiac surgery. The unit provides tertiary level care including full spectrum of invasive monitoring and lifesaving technology. The unit was initially an open icu which then converted to a closed ICU in 2003 when the first Intensivist Dr Mohammed Shamsah joined the department. Coming from a cardiac anesthesia and chronic pain background in addition to a special interest in physiology, he introduced a number of services including using invasive monitoring, imaging and mechanical circulatory support for aiding diagnosis and treatment in the intensive care unit. The unit currently utilizes PA catheter, USS, and echocardiography as well as IABP and ECLS as part of its management. The unit provides a multidisciplinary care where the ICU team consists of physiotherapists, clinical dieticians, and pharmacists in addition to speech and language therapists working alongside the physicians. In 2017, ECMO service was established in the unit and it became the first ECLS center in the intensive care providing retrievals from different parts of the county. AL-Adan ICU is an ELSO GOLD CENTRE OF EXCELLENCE and runs regular ELSO endorsed ECLS courses since 2020.