Tuanku Mizan was born on 22nd January 1962 at Al-Muktafi Palace,Kuala Terengganu. He is the first son of the Yang di-Pertuan Muda(Crown Prince) of Terengganu, Tengku Mahmud (then Sultan Mahmud) with Sharifah Nong Fatima and the eldest from seven siblings.
Tuanku Mizan was proclaimed as the Yang di-Pertuan Muda(Crown Prince) of Terengganu on 6th November 1979 when he was 17 years old.
He married Tuanku Nur Zahirah on 28th March 1996 at Maziah Palace, Kuala Terengganu.They were blessed with four children. Two princes and two princesses
He was proclaimed as the 17th Sultan of Terengganu after the death of his father, Sultan Mahmud Al Muktafi Billah Shah on 15th May 1998.
His coronation as the Sultan of Terengganu was held on 4th March 1999.
He was elected as the Deputy of Yang Di Pertuan Agong on 26th April 1999. His proclaimation as the 13th Yang di Pertuan Agong was held on 13th December 2006 at National Palace, Kuala Lumpur.
His eldest son Tengku Muhammad Ismail was proclaimed as the Regent of Terengganu on 12th December 2006 at Maziah Palace. Tengku Muhammad was bestowed Darjah Kerabat of Terengganu in the ceremony.
His coronation as the 13th Yang Dipertuan Agong was held on 26th April 2007 at National palace, Kuala Lumpur.
His Majesy's reign ended on 12th December 2011 and will be replaced by the Sultan of Kedah, Tuanku Abdul Halim Muadzam Shah that will be formally installed on 13th December 2011