Huge amounts of energy are consumed by hospitals to improve the health environment for patients. This energy needs to be stable and continuous. Therefore, it is necessary to manage energy consumption. The purpose of this research is to study the energy management performance in hospitals in Saudi Arabia aiming to develop theoretical framework for energy management and to provide guideline to support implementing an effective energy management system in hospitals. This research consists of two main parts. The first part involves the assessment of the level of energy management program and the gathering of energy consumption quantitative data from five hospitals in order to determine the level of implementation of energy management program and the amounts and percentage of annual change in electricity consumption per bed in hospitals. The second part involves the inspection of the opinions of hospital top technical managers regarding energy management in their hospitals and their knowledge in auditing procedures, energy efficiency barriers, awareness to energy management and percentage of expected amount of saved energy. The research delivers recommendations tailored to the health sector in Saudi Arabia that encourages implementing energy management programs in hospitals to save energy, increase energy efficiency and improve energy management awareness.