This work presents the construction procedures and pile load test results of large-diameter bored and grouted cast-in-place concrete piles in coral formations and carbonate sediments in the Red Sea. Construction details and difficulties involved in the process of site preparation, borings, reinforcement, concrete casting, and grouting are described and discussed. Geotechnical engineering considerations that led to the selection of this type of foundation and the conditions of the site are included. Key words: pile foundations, bored and grouted, marine sediments, construction methodology, load testing.