The islands were seen as being of key strategic significance, lying between Gibraltar and the Suez Canal, and became an important shipping station on the sea route between Great Britain and British India.

In 1921, this was replaced with a fully elected bicameral parliament, which brought Malta a degree of Home Rule within the British Empire.

A depiction of the distinguished medal has remained on the Maltese flag to the present day (in a red fimbriation after its original blue canton was removed in 1964).

After independence, a defence agreement, coupled with a financial aid package, allowed the continued use of Malta by British armed forces and the island was the Mediterranean headquarters of NATO.

Since the Brexit referendum, the number of applications for Maltese citizenship by British citizens, based on either family link or long-term residence, has seen a spike from 382 in 2016 to 619 in 2017 and 704 only in the first 10 months of 2018.