Mizan Zainal Abidin was born at the Istana Al-Muktafi in Kuala Terengganu, the eldest son of Sultan Mahmud by his second wife, Fatimah Sharifah Nong Alsagoff binti Abdillah.

Sharifah's family is of Arab descent, from Sayid Omar Aljunied (her maternal great-grandfather), one of the modern pioneers of Singapore.

Terengganu, where the Barisan Nasional won two-thirds of the seats in the state parliament, was the last to appoint a Menteri Besar (Chief Minister) after the 2008 general elections.

[4] On 26 March, Prime Minister Abdullah Ahmad Badawi and Sultan Mizan Zainal Abidin met at the Istana Negara to resolve the impasse.

He also apologised to the King for the public dispute over the appointment of the Menteri Besar, explaining that there was no intention to disparage or humiliate the royal household.

The royal couple have two sons and two daughters: After Sultan Mizan was elected as the Yang di-Pertuan Agong, he appointed Tengku Muhammad Ismail, then aged eight, as regent on 12 November 2006.

[8] Because of Tengku Muhammad Ismail's young age, a three-member Regency Advisory Council was established to discharge his duties for him.

However, the Sultan formed another council, Majlis Perwakilan Pemangku Raja, to perform the Regent’s duty while he was away from Terengganu pursuing his studies.

In addition, the Global Taekwondo Federation (GTF) awarded Mizan an Honorary 7th Degree Black Belt in recognition of his active participation in the sport.