Most countries have been experiencing changes in fertility pattern over the last few decades. Fertility transition from high to low is a relatively recent phenomenon in Malaysia. The total fertility rate (TFR) had declined from 4.9 children per woman in 1970 to 4.0 in 1980. It has continued to fall and has reached the replacement level of 2.1 in 2010. This chapter provides the trend analysis and a comparative analysis of fertility trends to explain the fertility transition of Malaysia’s population. Data used in this study were obtained from Department of Statistics, Malaysia and Fifth Malaysian Population and Family Survey, 2014. The result of this study showed that the fertility rate between age groups was higher among Malay than other ethnics since 1991–2010. Across all ages, the fertility rate has a negative correlation with the educational level where women with tertiary education tend to have fewer children compared to less educated women. This study also presents the fertility desire in Malaysia. There is a negative correlation between age group and fertility desire. In addition, the desire to stop childbearing is found to be stronger when women have had three living children. The findings of this study will help policy makers to plan programmes to improve the fertility rate in Malaysia.