He started his business in the early 1980s and specialised in bridal couture (expensive fabrics, lace, gemstones, Swarovski crystals, pearls, detailed embroidery, etc.).

At first his atelier specialized in bridal couture, making wedding dresses and gowns using expensive fabrics, lace, detailed embroidery, pearls, crystals and silk threads.

[citation needed] Saab, Tina Knowles, House of Deréon, Giorgio Armani, Versace, and Herve Leger served as the designers for the outfits of the 2007 The Beyoncé Experience tour.

[20] In 2011, Madame Tussauds unveiled a wax statue of Kate Winslet draped in the Elie Saab dress she wore at 63rd Primetime Emmy Awards.

[3] As of 2013, the brand had boutiques located in Beirut, Dubai, Doha, Paris, London, Geneva, Hong Kong, Moscow, New York City, and Mexico, with 100 retail outlets total.

The luxurious gated island property, Grand Bleu Tower at Emaar Beachfront, will include one, two and three-bedroom apartments as well as four-bedroom penthouses with interiors by Elie Saab.

[26] Saab's main office and headquarters were left badly damaged by the explosion, his home nearby was completely destroyed.

[27] In April 2021, Elie Saab launched an initiative that consists in donating a portion of sales to UNICEF's "Integrated Education and Well-Being for Vulnerable Girls in Lebanon Program.

[34] First Lady of France Brigitte Macron wore an Elie Saab outfit of military coat and skinny trousers during a state visit to China.

[45] Jennifer Lopez has worn Elie Saab on many occasions, including the 87th Academy Awards,[46] 45th Los Angeles Film Critics Association Awards,[47] Global Citizen's Vax Live: The Concert to Reunite the World,[48] and Elie Saab's Paris Haute Couture Show.

[49] Other notable clients of Saab's work have included Nicole Kidman,[50][51] Eva Green, Beyoncé,[29] Aishwarya Rai,[52] Anna Kendrick,[53] Christina Aguilera,[54] Catherine Zeta-Jones,[29] Angelina Jolie,[55] Celine Dion,[56] Elena Anaya,[52] Elsa Zylberstein,[52] Heidi Klum,[57] Karlie Kloss,[58] Dame Helen Mirren,[59] Emilia Clarke,[60] Priyanka Chopra,[61] Sonam Kapoor,[62] Kendall Jenner,[63] Taylor Swift,[64][65] Tiffany Trump[66] and Ons Jabeur.

[24] In January 2018, Saab received backlash on social media after his label's Instagram account posted a picture of Israeli actress Gal Gadot wearing one of his dresses to the National Board of Review awards with the caption "A flawless Gal Gadot in Elie Saab Ready-to-Wear Spring Summer 2018 at the national board of review annual gala in New York".