The party contested six elections when it was being led by Altaf Hussain. At the centre, it won 19 general seats in 2013, 19 in 2008 and 17 in 2002. In 1997 and 1990, it contested under the Haq Parast label and secured 12 and 15 general seats respectively. In 1988, MQM members ran as independents and won 13 seats.
MQM-Pakistan, in its current form, took shape when the sun set on Altaf Hussain's political fortunes following his anti-Pakistan speeches from the party then headquarter in London. Senior party leader Farooq Sattar took the reins of the party and announced that MQM no longer had anything to do with Altaf. The party was christened with the name MQM-Pakistan to indicate a permanent break from the London group.
Though internal rifts marred the party's early days, its leadership tried to highlight the issues of the urban Sindh vote bank.
Dissociated from the London group and newly-formed Pak Sarzameen Party (PSP) posturing for influence, MQM-Pakistan witnessed more than a dozen lawmakers and scores of party workers defecting to the Mustafa Kamal's and other parties.
Without naming the establishment, the MQM-Pakistan leadership has complained on several occasions that its leaders have been forced to leave the party. They have also alleged that the party was being subjected to discrimination and prejudice.
Citing the day-long captivity of the party's central leadership by Sindh Rangers, political observers believe that the establishment had a role in crafting a minus-Altaf MQM. However, Major General Mohammad Saeed, Director General of Sindh Rangers, has unequivocally denied any role in the creation of MQM-Pakistan, saying the party's dissociation from its London-based supremo was an internal matter.
Notorious former SSP Malir Rao Anwar had arrested MQM-P's central leader Khawaja Izharul Hassan on September 16, 2016, accusing him of abetting target killers and wrongdoers.
On November 8, 2017, leaders of both PSP and MQM announced they were joining hands and would contest the 2018 general elections under "one name, one manifesto, one symbol and one party". Less than a day later, the alliance came to an end, and in a familiar 'MQM style' resignation, Dr Sattar announced he was resigning from the party's leadership just to withdraw that decision after intervention from his mother as well as surrendering before the pressure of party workers.
On Feb 12, then MQM-Pakistan chief Sattar claimed that he had been removed as party convener by some members of the party's coordination committee so former military ruler Pervez Musharraf could replace him. Musharraf, however, rejected the notion of leading any faction of the party even if he was offered the position.
In February 2018, a row over the nomination of candidates for the March 3 Senate elections turned into an open rebellion against Sattar as the party’s top decision-making forum removed his favoured candidate Kamran Tessori from the coordination committee and suspended him for six months. Subsequently, the committee removed Sattar from his post and appointed Khalid Maqbool Siddiqui as the new leader. In a tit-for-tat reaction, Sattar dissolved the committee and had himself re-elected through intra-party elections. The party practically divided into two groups: MQM-PIB (Pir Illahi Bux Colony), the area where Sattar resides and ran party affairs from and MQM-Bahadurabad, the area where Siddiqui and the committee ran their affairs from. After a months long power struggle, Sattar reconciled with the idea of Siddiqui as convener after the IHC ruled in the latter's favour.
Under Altaf Hussain, MQM was formed as a political party fighting for the rights of the Urdu-speaking people who had emigrated to Pakistan around Partition (commonly known as the Mohajir community, which dominates Karachi and other parts of lower Sindh). At the time, MQM stood for Mohajir Qaumi Movement, as opposed to the current Muttahida.
In 1988, the Altaf-led MQM swept the election in Sindh’s urban areas and entered into a cooperation agreement with PPP, enabling it to become part of the government. However, differences developed between the parties and in 1989 the alliance fell apart.
In its formative years, the party also saw the formation of a breakaway faction — MQM - Haqiqi. Although the group did not have much of an impact on capturing the original party’s vote bank, it did feature in the increased levels of unrest in Karachi and the notorious 1992 operation.
The well-known Operation Clean-up was preceded by increased political and ethnic violence in urban Sindh. The crackdown drove several MQM leaders and workers into either hiding or leaving the country. Azeem Tariq, the co-founder of the party, was assassinated in 1993, while Altaf Hussain left for London and remains in self-imposed exile to this day. The crackdown on MQM continued through much of the 1990s.
The MQM saw a definitive shift in ideology and organisation in July 1997 when its leadership decided to replace the word “Mohajir” from its name with Muttahida, meaning ‘united’. This shift was prompted by the realisation that it had become imperative for the party to progress from representing a community to adapting to the changing ethnic and cultural dynamics of its power bases of Karachi, Hyderabad and other parts of lower Sindh. The logic also entailed that the party may play a greater role in national politics.
In 2015, the Altaf-led MQM’s fortunes began to dwindle. Rangers raided Nine Zero, the party’s then headquarters, and arrested several MQM leaders. They also recovered weapons and ammunition from the premises. In the coming months, Altaf Hussain further fell out of favour with those wielding powers in Pakistan. Eventually, he was ousted by his own party which went on to become MQM-Pakistan.