Introduced in Mortal Kombat II (1993), Mileena was initially depicted as a clone of the Edenian princess Kitana, created by Shang Tsung with the blood of the fictional Tarkatan species.

Mortal Kombat co-creator and producer Ed Boon described Mileena and Kitana as the "female version of Scorpion and Sub-Zero", two ninja characters from the 1992 original game.

[11] She was physically identical to Kitana save for her pink outfit and large gnashing teeth, which were created to tie in with fellow debut character Baraka in symbolizing evil in the game.

[12] Character designer John Tobias chose the name "Mileena" as he felt "it had a pleasant sound to it, which either helped hide her grotesque appearance or exposed a hidden inner beauty", while her and Kitana's storylines in Mortal Kombat II were borne from "the conflicts of sibling rivalry and rebelling against authority".

[31] To keep her from learning about her past, Kahn orders the sorcerer Shang Tsung to create a clone for the purpose of spying on Kitana and ensuring her loyalty to him, and to replace her if necessary.

However, Shang Tsung combines Kitana's genetics with that of the brutish Tarkatan race, resulting in Mileena having the latter's characteristic mouth of razor-sharp teeth that she conceals with a mask.

[36] In Mortal Kombat: Armageddon (2006), Mileena seizes Kahn's fortress while maintaining her deception until she feels Edenia's forces are ready to serve her under her true identity.

[47] Mileena also secretly suffers from the Tarkat virus, a mutating disease that slowly transforms the afflicted into feral monsters, and uses a serum developed by Shang Tsung to keep it at bay.

[53] Stringer, who underwent four months of martial arts training in preparation for the role,[54] did not actively seek the part but was drawn to the character following a costume fitting and screen test.

[61] She and the other MKII characters appeared in the Malibu Comics miniseries Goro: Prince of Pain (1994) and Battlewave (1995),[62][63] while she was featured in the one-shot issue Kitana and Mileena: Sister Act (1995).

[65][66] According to series writer Shawn Kittelsen, "Kotal didn't overthrow Mileena in some macho power play; he overthrew her out of genuine concern for the safety and well being of Outworld and its citizens".

[74] The compilation album Mortal Kombat: Songs Inspired by the Warriors (2011) included a track by electronica musician Tokimonsta titled "Mileena's Theme".

[77][78][79] Mileena's debut playable appearance in Mortal Kombat II, combined with her evil characterization and revealing clothing, was met with favorable critical reception and made her one of the franchise's most recognizable characters.

[88][89][90][91] Gavin Jasper of Den of Geek opined in January 2015 that the Mortal Kombat games received legitimate criticism for its "over-sexualized" female characters, "but I always thought it was pretty funny of them to focus the male gaze on the monster-faced woman.

"[93] Mileena and Kitana were the subject of an article by researcher Jane Felstead, who commented that while the intention of female characters was to cater to gamers of both sexes while possessing equal physical capabilities, they were nonetheless created to satisfy the male gaze.

She praised the physical appearance of MKII actress Katalin Zamiar in that "in no regard was she unrealistic", but with the onset of three-dimensional animation, female characters such as Mileena were "impossibly idealised".

Felstead nonetheless suggested that Mileena and Kitana both "perform their gruesome tasks with as much finesse as their male counterparts" while the in-game action is "traditionally seen as male-coded behaviour, and yet in this case infiltrated by a number of strong, capable women.

[106] Renaldo Matadeen of Comic Book Resources praised their relationship but criticized the games' "past failures" at inclusivity such as the "mishandled queer narrative" of Kung Jin, an LGBT character introduced in Mortal Kombat X who has made no other series appearances.

[107] Lindsay Cooper of Capilano University described in-game lesbian relationships such as Mileena and Tanya as implicitly depicted in contrast to explicit stereotyping of male homosexuality, citing Streets of Rage 3 character Ash as an example.

[108] History professor Leonardo Dallacqua de Carvalho observed that MK1's rebooted storyline included "identity issues" like Mileena's relationship and the "empathetic" subplot of her and Baraka living with the Tarkat disease, which he likened to leprosy.