This paper provides a review of the use of open hole multistage (OHMS) completions in Saudi Arabian carbonate and sandstone applications. While operational and functional challenges were initially encountered, OHMS completed wells resulted in increased initial production and less departure from the theoretical hyperbolic decline curves. This paper outlines the challenges encountered, reviews the risk mitigation process and details how the various issues were overcome. Best practices regarding installation, wellbore trajectory to optimize transverse fracture initiation are outlined. The paper also compares long-term production results with non-OHMS wells, and explores other initiatives where OHMS systems can further improve well performance.