Fakih was born in Srifa, a small city in the Jabal Amel region of Southern Lebanon, to a "powerful" Shi'a Muslim family. Her mother hails from the Chebli - Fawaz family in Tibnin Lebanon As a young child, she lived in the village of Souk El Gharb in Mount Lebanon, and attended St. Rita's, a Catholic school near Beirut.^[10][11] In 1993, her family moved to New York, where she later attended St. John's Preparatory School, a Catholic high school.^[5] Her family moved to Dearborn, Michigan, in 2003.^[10]

Fakih and her family are Muslim, but they also celebrate elements of Christianity, such as Christmas.^[7][12][13]

Following the Miss USA pageant, internet entertainment media directed attention to a website featuring a 2007 "Stripper 101" pole dancing contest sponsored by Detroit radio station WKQI and won by Fakih.^[14] WKQI said they had been contacted by representatives of the Miss Universe Organization, requesting additional photographs and information about the contest. The station expressed their support for Fakih, adding "the photos taken from our website are no more provocative than those on the Miss USA website."^[15] On May 18, Miss USA pageant representatives told ABC News they would proceed with their media tour starring Fakih.^[16] She was also an actress in an independent short film with sexual undertones titled Throbbing Justice.^[17]

During and after the Miss USA pageant, Fakih's religious and ethnic identity became the subject of widespread discussion. On the subject of identity, she was quoted as saying "I'd like to say I'm American first, and I am an Arab-American, I am Lebanese-American, and I am Muslim-American."^[18]

Many Arab Americans celebrated Fakih's victory,^[12] but some Muslims felt she did not properly represent their religion. Muslim scholar Ghazal Omid wrote "To say that she is a Muslim is inaccurate. No Muslim woman can call herself a ... Muslim and be on stage with her bikini".^[19] Responding to the issue in interviews, Fakih said she and her family are Muslims and respect the religion, but they may not be as strict as many people and do not define themselves by their religion; they view themselves as more "spiritual" than "religious" and appreciate all religions.^[8][20][21]

Fakih resides in Dearborn.^[22] She graduated from the University of Michigan–Dearborn with degrees in economics and business management, and plans to attend law school after her year-long reign.^[13] She has a sister, who returned to live in Lebanon, and two brothers.^[10]

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