Mistletoes, particularly members of the family Loranthaceae, are obligate hemiparasitic plants that influence host-tree physiology and ecosystem functioning. In Saudi Arabia, their ecological effects and management requirements may vary with host identity, infestation severity, climatic conditions, and land-use context. This systematic review synthesizes the available literature on the diversity, distribution, host associations, ecological impacts, and management of mistletoes in the Kingdom. Six native Loranthaceae species are considered: Tapinanthus globiferus, Oncocalyx glabratus, O. schimperi, Phragmanthera austroarabica, Plicosepalus curviflorus, and P. acaciae. Available studies indicate that these species are associated primarily with mountainous and other suitable habitats, particularly in western and southwestern Saudi Arabia, although their distributions and host ranges differ. Mistletoes establish vascular connections with host plants through specialized haustoria, enabling the uptake of water and mineral nutrients. Under severe infestation or water-limited conditions, these interactions can contribute to host-tree stress, crown deterioration, and reduced productivity. Studies from Saudi Arabia and comparable arid environments have identified Vachellia and Juniperus species, as well as cultivated fruit trees, as relevant host groups. Mechanical removal and pruning are established management approaches, whereas the suitability of chemical and biological controls requires further evaluation under local environmental conditions. However, quantitative evidence on infestation severity, host mortality, economic losses, and long-term population dynamics in Saudi Arabia remains limited. Future research should prioritize systematic field monitoring, standardized infestation assessments, spatial distribution mapping, and evaluations of management effectiveness. Integrating species-specific biological knowledge with locally validated management practices could support the conservation and sustainable management of the Kingdom’s forest and agricultural resources.