Malcolm Mifsud read law at the University of Malta. He specialised in maritime and shipping law at the IMO International Maritime Law Institute.

Dr Mifsud started his career by joining one of the then largest law firms in Malta and was assigned maritime, civil and commercial litigation cases. In December 1998, he co-founded the law firm Griscti & Mifsud Advocates and was responsible for the litigation department within the firm. In 2007, Dr Mifsud, together with his brother Cedric Mifsud, set up another law firm, Mifsud & Mifsud Advocates, where he is responsible for the civil and commercial litigation practice. He is also a director of the corporate services company Aegis Corporate Services Limited.

Dr Mifsud has held a number of public posts. He was the director of Gozo Channel Company Limited (1999–2003), legal reviser at the translations unit at the Ministry of Justice and Local Government (2002–2003) and an advocate for legal aid.

Dr Mifsud was elected five consecutive times as Mayor of Pietà. In June 2009, he was elected president of the committee of the Central Region and was also appointed as a member of the EU Committee of the Regions.