In it, Mahathir describes his interpretation of Malaysia's history in relation to its multi-ethnic society and racial tensions, and advocates for affirmative action policies for Malays.

At the time of publication, Mahathir had just lost his parliamentary seat, been expelled from the ruling party UMNO and Malaysia had recently been rocked by the racial riots later known as the 13 May Incident.

The book has attracted controversy for making racial generalisations, such as describing "Jewish stinginess and financial wizardry"[1] and calling Jews "hook-nosed".

[2] Mahathir proposes in the book that affirmative action policies be a solution leading away from violence towards a harmonious, integrated Malaysia, albeit one where political and economic power is firmly concentrated in the hands of the Malays.

Mohammad Bakri Musa, in The Malay Dilemma Revisited (1999) states that his assertions and assumptions were based on his personal observations and experiences, with no empirical data to support them.