TPPA stands for Trans Pacific Partnership Agreement (TPPA) and is also known as the Trans-Pacific Strategic Economic Partnership Agreement. It is a multilateral free trade agreement currently being negotiated by 12 countries, led by the United State (US). Malaysia is one of the parties negotiating in the TPPA. It aims to further liberalize the economies of the Asia-Pacific region, covering a broad spectrum of areas and has 29 chapter's altogether and some areas affect our public health, environment and courts system. The TPPA have their own advantages and disadvantages and this paper is to discuss the advantages and challenges of TPPA in general that Malaysia will be faced if Malaysia signed the TPPA and the likely impact of TPPA on health in Malaysia. The analysis result by UNDP showed if Malaysia does not join the TPPA, Malaysia would be at a disadvantage in terms of seeking bigger and better market access for Malaysian products and services. Analysis on the TPPA document showed if Malaysia signs the TPPA, it will have an impact on the cost of medicines and health matters. In conclusion, the government has to be very careful in dealing with TPP agreement to ensure the advantages in favor of Malaysia. Every action needs to be refined and addressed with care otherwise Malaysia has to bear all the cost in health sectors.