Sangma led the Congress to win a record 29 seats in the 60-member House, though two short of a majority.
Over the years he served not only as deputy chief minister, but was also given some most important portfolios like home, finance, power and health.
Sangma joined active politics in 1993 after relinquishing service as medical and health officer at Zikzak PHC and was elected to the assembly from Ampatigiri as an independent candidate to be appointed chairman of the Meghalaya Transport Corporation.
In 2003, he became the home and education minister in the D D Lapang ministry.
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In 2005, he was appointed the deputy chief minister but was forced to resign on October 7 that year after five persons were killed in police firing at Williamnagar in East Garo Hills district and four persons at Tura in West Garo Hills district on September 30 during an agitation against a state-level committee's recommendations on restructuring of the Meghalaya Board of Secondary Education.
In 2009, he again became deputy chief minister of Congress-led Meghalaya United Alliance government led by chief minister D D Lapang.
Sangma was born on April 20, 1965 at Chengkompara village in the present day West Garo Hills district to Binoy Bhushan M Marak and Roshana Begum.
He completed his school education from the Government High School in Ampati in 1982 and passed his pre-university examination in Science from St. Anthony's College in Shillong in 1984.
He graduated in medicine from the Regional Institute of Medical Sciences (RIMS) in Imphal in 1989.
While studying, he occupied a number of positions in the governing body of the Students Council of RIMS while he was in the Youth Congress.
He joined as a medical and health officer at Zikzak Public Health Centre in 1991.