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Al-Qadsiah have been a regular and uninterrupted participant in the Saudi Premier League since its inception in the inaugural 1976-77 season, their best ever top-flight season came in the 1980–81 season when they finished in 3rd place. Al-Qadsiah's most successful period in their history came in the early 90's when they won the 1991-92 Crown Prince Cup against Al-Shabab 4–2 on penalties to claim their first ever top flight title. The club's cup win qualified them for the Asian Cup Winners' Cup, where they reached the final to face South China whom they beat 6-2 on aggregate to clinch the 1993–94 title. In the same season they also picked up the 1993–94 Saudi Federation Cup by beating Al-Nassr 2-0 in the final. After 21 consecutive seasons in the top flight, as well as achieving two domestic titles and one continental title the club was relegated for the first time in their history in the 1996–97 season.

Following the club's first relegation, Al-Qadsiah have become inconsistent in their performances, yo-yoing between divisions with five promotions and relegations since the 1999–2000 season.

In the summer of 2023 Ministry of Sports announced that Al-Qadsiah, together with 7 other clubs in Saudi Arabia, are transformed into companies and Al-Qadsiah become owned by Saudi Aramco. The team, who competes in the Saudi First Division League, invest in transfers in order to fight for promotion to Saudi Pro League.