The level of infrastructure development Qatar has accomplished over the past 10 years has not been reached by any other country and this pace is expected to continue to achieve Qatar's 2030 Vision. High-rise buildings and bridges are mostly constructed on pile foundations which play an important role in overall cost of the project, but there is limited published literature available on the performance of pile foundations in Qatar. In this article, the performance of fully instrumented pile foundations embedded in rock formations of Qatar is reviewed, and discussion on observed behaviour is presented. This paper also uncovers the conservatism in pile design adopted by the piling industry. A total of more than 65 pile load test results were compiled to perform this study. Good practices are suggested that can be considered by the authorities and consultants in specifying a preliminary pile load test in order to reap its full potential. In projects, where the unit skin friction was validated through performance of pile load tests and later on pile design was optimized, 11% to 50% savings in piling cost was achieved contributing to sustainable projects.