In May 2010 she represented Michigan at the Miss USA 2010 pageant held at the Planet Hollywood Resort and Casino in Las Vegas, Nevada.
Fakih did not place as a semi-finalist and was the first Miss USA since Shauntay Hinton, Miss USA 2002, to not place at the Miss Universe pageant.
Fakih appeared as a guest star on the November 29, 2010, edition of WWE Raw, where she crowned Sheamus, the winner of the King of the Ring tournament.
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In 2016, Fakih converted to Christianity from Shia Islam, and married Lebanese-Canadian music producer Wassim Slaiby known as Tony Sal.