This paper examines Malaysia’s evolving relations with China during the second Mahathir administration from 2018 to 2020 in political, economic, and security aspects. While much of the foreign media portrayed the unprecedented change of government in May 2018 as an instance of “pushing back” against China, this paper refutes this simplistic view. It argues that while there were uncertainties in bilateral relations in the initial period following the election, the “Mahathir 2.0” administration ultimately renewed and reaffirmed its relationship with China on a positive note. Economically, the Mahathir 2.0 administration sought to renegotiate Malaysia’s economic relationship with China to align it with its political economy agenda. In terms of security, Prime Minister Mahathir had at first sought to form a new normative framework but later came to adopt a more assertive stand in the South China Sea dispute. At the same time, he showed a continued (but cautious) willingness to engage in defense diplomacy and military-to-military relations with China. This paper analyzes these developments in light of the theoretical framework of neoclassical realism which takes into account the systemic, domestic, and personal factors in influencing the country’s foreign policy. It also interprets these developments as exercises in hedging by a small power in an age of increasing uncertainty.