Mahathir Mohamad was inaugurated as Malaysia's seventh Prime Minister in May 2018, succeeding Najib Razak, whose term was tainted by the 1MDB scandal, the unpopular 6% Goods and Services Tax, and increasing living costs. Under Mahathir's leadership, efforts to "restore the rule of law" were promised, with a focus on transparent inquiries into the 1MDB scandal. Anwar Ibrahim, a key political figure, was granted a royal pardon and released from incarceration, with the intent of him eventually succeeding Mahathir as agreed upon by the coalition.

Mahathir's administration took significant economic and diplomatic measures. The contentious Goods and Services Tax was abolished and replaced by the Sales Tax and Service Tax in September 2018. Mahathir also reviewed Malaysia's involvement in China's Belt and Road Initiative projects, labelling some as "unequal treaties" and linking others to the 1MDB scandal. Certain projects, such as the East Coast Rail Link, were renegotiated, while others were terminated. Additionally, Mahathir displayed support for the 2018–19 Korean peace process, intending to reopen Malaysia's embassy in North Korea. Domestically, the administration faced challenges when addressing racial issues, as evidenced by the decision not to accede to the International Convention on the Elimination of All Forms of Racial Discrimination (ICERD) due to significant opposition.

Towards the end of his term, Mahathir unveiled the Shared Prosperity Vision 2030, aiming to elevate Malaysia to a high-income nation by 2030 by bolstering the incomes of all ethnic groups and emphasizing the technology sector. While press freedom saw modest improvements during his tenure, political tensions within the ruling Pakatan Harapan coalition, combined with uncertainties over the leadership transition to Anwar Ibrahim, eventually culminated in the Sheraton Move political crisis in February 2020.