known as Order of Royal Family on 16 January 1999 and Bintang Kebesaran Darjah Seri Setia Sultan Mahmud Terengganu Yang Amat Terpuji (S.S.M.T.)

– Grand Order of Nation Crown on 5 April 2007 when she became Her Majesty Seri Paduka Baginda Raja Permaisuri Agong of Malaysia.

She played a major role during the Humanitarian response to the 2004 Indian Ocean earthquake by collecting donations which were successfully distributed to victims through both the Acheh and Kedah governments.

In 2006, the Yayasan DiRaja Sultan Mizan, a local foundation of the royal family of Terengganu, represented by the queen distributed milk bottle especially for cleft-lipped babies, breast pumps for mothers and related devices to help people with eyesight problems through Hospital Sultanah Nur Zahirah.

Sultanah Nur Zahirah was conferred with an honorary doctorate in management at a special convocation of Universiti Malaysia Terengganu in 2006.

In her speech at the event, she urged the people of Terengganu to take the initiative to emulate the excellent accomplishments of past Muslim scholars in fields of knowledge, especially in science and technology.