Literature suggests that a thorough language needs analysis is very essential for curriculum development the goal of which is to help healthcare learners to be proficient and successful in English in both their academic study and professional workplace. Although English language course designers spend large amount of money in developing their curriculum, they often neglect the process of a needs analysis which is considered to be an important first step when planning any English language course. Unfortunately, English language courses taught at the Health Sciences Colleges in Saudi Arabia, too, have been developed without carrying out a needs analysis. The purpose of this paper is to discuss the importance and necessity of identifying the academic and professional English language needs of students of Health Sciences Colleges in Saudi Arabia. It also proposes a needs analysis framework for the development of ESP course at these colleges.