Background. Globally, we are facing a “terror epidemic” with incidences of terrorist attacks on innocent civilians increasing worldwide. The volume and nature of injuries resulting from such attacks challenge even the most sophisticated and well-prepared trauma systems and health institutions. Over seventy percent of terror attacks involve bomb explosions with improvised explosive devices (IEDs) resulting in a unique pattern of injuries to the victims. Here, we present data on the terrorist attacks on the city of Riyadh, Saudi Arabia, between March 1991 to the present and discuss in retrospect the event outcomes and features which may be useful for the preparedness of the intensive care unit (ICU) in the wake of future attacks. Methods. Data from nine hospitals in Riyadh that catered to patients during terrorist strikes were collected retrospectively. Details of the incidents were collected from news media archives. Results. The majority of terror strikes (~80%) involved a bomb blast with the use of explosives. The victims included 148 casualties, 45 hospitalizations, 103 discharges after first aid, and 3 incidences of admission to the critical care unit. Conclusion. Using the Riyadh experience, we analyze data and the series of events in the ICU following terrorist explosions. The analysis provides important insights for the trauma unit so that it is better prepared and organized for such incidents in the future.