The Malaysian Burden of Disease and Injury Study (MBOD) 2019 provides a comprehensive assessment of Malaysia’s health landscape by quantifying disease and injury burden using Disability-Adjusted Life Years (DALYs). The study aligns national priorities with global standards by curating a 162-cause disease list adapted from the Global Burden of Disease (GBD) framework, incorporating local health priorities, including tropical diseases, and harmonising data sources using ICD-10 coding. Improvements in mortality estimation and integration of diverse national datasets, including health surveys and disease registries, enhanced the accuracy of burden estimates. In 2019, Malaysia recorded 3.43 million Years of Life Lost (YLLs) due to premature mortality and 2.19 million Years Lived with Disability (YLDs), resulting in a total of 5.62 million DALYs (61% YLL; 39% YLD). Males accounted for 56.6% of total DALYs. Cardiovascular diseases were the leading contributors to overall burden, followed by neoplasms, and diabetes and kidney diseases. The leading causes of DALYs were ischaemic heart disease, stroke, diabetes mellitus, lower respiratory infections, and road injuries. Disease burden varied by age and sex, with neonatal conditions dominating in children under five, road injuries among those aged 15–29, and cardiovascular diseases among adults aged ≥30 years. Overall, MBOD 2019 identifies ischaemic heart disease as the leading cause of total disease burden in Malaysia and highlights the growing dominance of non-communicable diseases. The study provides robust, nationally relevant evidence to guide public health policy, priority setting, and resource allocation, supporting targeted interventions particularly for cardiovascular diseases and diabetes mellitus. Technical report: https://iku.nih.gov.my/images/teknikal-report/malaysian-burden-of-disease-and-injury-study-2019.pdf Infographic: https://iku.nih.gov.my/images/teknikal-report/infographic-malaysian-burden-of-disease-and-injury-study-2019.pdf