Al-Ruwaini worked for Qatar TV and MBC before establishing her own production company, Pyramedia Ltd. Pyramedia is one of the largest and most successful production companies in the region, producing some of the highest-rated TV shows, including the Million’s Poet and Prince of Poets TV competitions on Abu Dhabi TV, as well as her self-titled ‘Nashwa’ talk show on Dubai TV. Forbes listed her among The Top 100 Most Powerful Arab Businesswomen 2020 while the Hollywood Reporter selected her as one of the 25 Most Powerful Women in Global TV.