Objective: This study aims to understand in-depth the factors that motivate sex work among trans women, how they source their clients, and to explore their knowledge, attitude, and practices on safe sex. Method: In this qualitative study, a case study approach was selected to explore the motivating factors related to sex work, the factors that encourage sex work, and the safe sex practices among trans women in Northern Malaysia. The snowball sampling method was used and thirteen in-depth interviews were conducted using a semi-structured interview guide. Result: Financial reason was the main motivating factor for sex work. Most of them used online applications or websites to source clients and some used pimps who play an important role in sex education and protection. These trans women were well aware and equipped with knowledge on safe sex, and the use of condoms and attended regular check-ups and counselling when needed. Conclusion: Trans women should not be discriminated against and denied proper employment which can lead them to sex work.