Shah began her career as a model, and one of her friends introduced her to television. Shah's first play, was the Punjabi-language Hari Bhari Chhaon, which was broadcast on Lahore Television. In 1989, Shah performed in Rashid Dar's television play Sauraj Ke Sath Saath, in which she played the role of a physically disabled girl. After that she appeared in a number of serials and plays.
Shah appeared in numerous films afterward, and by the 1990s, she was also pursuing a career in theatre dramas, such as Janam Janam Ki Meli Chadar. Shah also worked in stage shows as a dancer. In 2009 Shah performed a minor role in Syed Noor's film Majajan.
Her family initially disapproved of her career in films, but eventually her mother accepted her daughter's decision to be an actress. Her father, a senior government official, still disapproves of Madiha's career.
- Shoaib Ahmed. "CULTURE CIRCLE: Much-awaited Lollywood films all set for Eid". dawn.com. Retrieved 16 October 2015.
- InpaperMagazine. "Married Madiha". dawn.com. Retrieved 16 October 2015.