Abstract
This review explores the etiology, transmission, molecular epidemiology, economic impact, diagnostics, control measures, inactivated vaccine challenges, global epidemiological trends, and recommendations for foot-and-mouth disease (FMD), with a focus on Saudi Arabia. The O/ME-SA topotype is the predominant strain in the region, with high genetic similarity (88-98%) to strains in neighboring countries, highlighting significant cross-border transmission. Despite FMD being an endemic disease, comprehensive molecular epidemiological studies in Saudi Arabia remain limited. FMD caused by the foot and mouth disease virus (FMDV) poses substantial economic burdens and affects various livestock species. Its persistence in Saudi Arabia is due to inadequate vaccination coverage, weak surveillance systems, and logistical challenges. Insufficient outbreak response, vaccine hesitancy, and gaps in public awareness further contribute to disease spread. Transmission occurs through direct animal contact and indirect routes, with the virus surviving in the contaminated environment for up to 14 days, indicating indirect transmission, representing 70% of cases and a key factor in sustaining outbreaks. Diagnosis primarily relies on S-ELISA and RT-PCR, with RT-PCR offering higher sensitivity and specificity. Integrating these with advanced techniques like RT-LAMP, could enhance the rapid detection and response. Control measures include vaccination, surveillance, and movement restrictions, with efforts to improve vaccine thermostability and efficacy. Strengthening disease data collection is essential for monitoring trends and improving vaccine selection. The key recommendations for Saudi Arabia include enhancing vaccine development, improving surveillance systems, conducting vaccine matching studies, and adopting a One Health approach. Collaboration with international organizations, public education, and research into new strategies and technologies is crucial for effective FMD control and prevention.

Key words: Foot-and-mouth disease, Saudi Arabia, Control measures, Vaccine, Surveillance