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Objectives This study aimed to translate and validate the Malay version of the Patient Measure of Safety-10 (M-PMOS-10) for use in Malaysian healthcare settings. The study also sought to establish its content and face validity to ensure cultural relevance, psychometric validity and reliability in assessing patient perceptions of safety.Design A cross-sectional validation study.Setting The study was conducted in tertiary-level care at a teaching hospital in Kelantan, Malaysia.Participants 30 hospitalised patients participated in face validity assessment, while another 100 patients were involved in confirmatory factor analysis (CFA) for construct validation. Eligible participants were adults aged 18–60, fluent in Malay, clinically stable and without a formally diagnosed psychiatric illness.Primary and secondary outcome measures The primary outcome was the psychometric validation of the M-PMOS-10, assessed through CFA and internal consistency reliability (Raykov’s rho). Content validity was determined using expert evaluations, and face validity was assessed through cognitive interviews with patients. Secondary outcomes included descriptive statistics of patient safety perceptions.Results The M-PMOS-10 demonstrated excellent internal consistency (Raykov’s rho=0.929) and strong factor loadings (majority >0.70). CFA supported a revised single-factor structure (Comparative Fit Index=0.986, Root Mean Square Error of Approximation=0.067). Scale-Level Content Validity Index/Average method (Ave) (0.96) confirmed the relevance of the translated items, while Scale-Level Face Validity Index/Ave (0.87) indicated that patients found the questionnaire items clear and comprehensible. The mean total M-PMOS-10 score was 42.98 (SD=6.14), indicating positive patient safety perceptions, though communication regarding care plans showed room for improvement.Conclusions The validated M-PMOS-10 is a reliable and culturally appropriate tool for assessing patient safety perceptions in Malaysia. Its strong content and face validity reinforce its utility in patient safety research and clinical applications. Implementing this tool can help healthcare institutions identify safety gaps, refine staff training and improve communication strategies. Future studies should explore its applicability in different healthcare settings and assess its responsiveness to interventions to enhance patient safety.