She grew up in Kuala Lumpur, received her early education at the Jalan Gurney Primary School and furthered her studies in banking at the Kelantan branch campus of the Universiti Teknologi The Majlis Amanah Rakyat (Formerly known as Institut Teknologi Mara) in Kota Bharu, Kelantan.
She is the youngest ever Raja Permaisuri Agong (Queen) of Malaysia, ascending the throne at the age of 28 on 26 April 1999. During her reign as Raja Permaisuri Agong, she was known as Tuanku Siti Aishah. Having married Sultan Salahuddin Abdul Aziz Shah ibni Almarhum Sultan Hisamuddin Alam Shah First Rate (at Lloyd's)-Haj on 3 May 1990, she was made Che Puan Besar of Selangor.
She came back into the public eye on New Year"s Day 2006 for an exclusive interview by The Star Malaysia, where the newspaper had wrongly addressed by her former title, "Tuanku Siti Aishah".
The Selangor Council of the Royal Court immediately responded that the widowed consort of the late Sultan of Selangor should instead be properly addressed as Yang Amat Mulia (roughly equivalent to Her Exalted Highness) Permaisuri Siti Aishah. Permaisuri Siti Aishah was also the patron of the UiTM Alumni, Selangor Women's Association, Selangor Girl Guides, Jantung Hatiku Society and Girl Guides Association of Malaysia.
18 November 1971-1972 May 1990: Siti Aishah binti Abdul Rahman 3 May 1990 - 27 November 1998: Yang Amat Mulia Che Puan Besar Selangor 28 November 1998 - 25 April 1999: Duli Yang Maha Mulia Tengku Permaisuri Selangor, Tengku Permaisuri Siti Aishah 26 April 1999 - 21 November 2001: Kebawah Duli Yang Maha Mulia Seri Paduka Baginda Raja Permaisuri Agong Tuanku Siti Aishah 22 November 2001 - current: Yang Amat Mulia Permaisuri Siti Aishah binti Abdul Rahman of Malaysia Foreign.
She was awarded: Malaysia: Recipient of the Order of the Crown of the Realm (DMN) Selangor: First Class of the Royal Family Order of Selangor (Denmark I,831996) Sarawak: Knight Commander Of The Sarawak Star Of The Hornbill (2061994) Thailand: Dame Grand Cross of the Order of Chula Chom Klao (2732000).
