She won the Miss USA title on May 16, 2010, breaking a 5-year streak of Southern states winning and becoming the first Miss Michigan USA to win the national title since Kenya Moore in 1993.
Fakih is widely believed to be the first Lebanese American, the first Arab American and the first Muslim to win the Miss USA title; however, pageant officials have stated their records are not detailed enough to confirm this claim.
She later competed on WWE Tough Enough on USA and was eliminated in week four.
Due to conflicting schedule with promotional events for Miss USA 2011, Fakih was the only contestant not to appear on the live final episode.
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." but some Muslims felt she did not properly represent their religion. 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.
She represented the state of Michigan in the national pageant, having previously won the 2010 Miss Michigan USA pageant.Fakih competed in her first pageant when she was nineteen, placing fourth runner-up at Miss Wayne County, a preliminary pageant for Miss Michigan in the Miss America system.She also competed in three smaller international pageants.In 2012, she participated in Fox's dating game show The Choice.On May 24, 2011, The Roots performed a freestyle song about her during her appearance on Late Night with Jimmy Fallon.Business at her father's restaurant reportedly declined following the September 11, 2001, attacks.She graduated from Henry Ford Community College and went on to earn degrees in economics and business management from the University of Michigan–Dearborn, and announced she planned to attend law school after her year-long reign.Fakih was born in Srifa, a small city in the Jabal Amel region of Southern Lebanon, to a Shi'a Muslim family.She is the daughter of Hussein and Nadia Fakih, and has four siblings, brothers Rabih and Rami, and sisters Rana and Rouba.The first Michigan delegate to win the Miss USA title, Carole Gist, became the first African-American Miss USA in 1990.During and after the Miss USA pageant, Fakih's religious and ethnic identity became the subject of widespread discussion.