Labuan, Miri, Kundasang and Raub regions of Malaysia have very different geological formations and settings that could result in different levels of natural radioactivity. Hence, this study determines the influence of different geological formations on radioactivity in these locations using field measurements, petrology and geochemistry. A total of 141 gamma dose rates and 227 beta flux measurements were collected using Polimaster survey meters (PM1405) in these four regions. The gamma dose rate values range from 0.37 to 0.05 µSv/h with a mean value of 0.11 µSv/h. Beta flux values range from 3.46 to 0.12 CPS with a mean value of 0.57 CPS. Mineralogy and elemental composition of the different rock types were analysed using thin-section petrography, XRD, ICP and pXRF methods. Felsic igneous rocks such as syenite and granite have higher natural radioactivity and contain more radionuclide-bearing minerals such as apatite, zircon, allanite, K-feldspar, titanite, muscovite and biotite. Metamorphic rocks have the second highest natural radioactivity and contain fewer radioactive minerals. The natural radioactivity of sedimentary rocks mostly depends on their clay content. The gamma dose rate maps show that igneous and metamorphic regions around Raub have higher radioactivity compared to the sedimentary-dominated regions around Miri and Labuan. Annual effective dose (AED) and excess lifetime cancer risk (ELCR) were calculated to evaluate the potential health risk for inhabitants of these regions. Labuan and Miri are considered to be safe zones with respect to natural radioactivity as the results show little to no risk for the public, compared with the Raub region, which is medium to high risk.