'malalignment' originates from the prefix 'mal-' (from French/Latin 'mal' / 'malus' meaning 'bad') combined with 'alignment' (from French 'alignement', from Old French 'aligner' related to 'ligne' meaning 'line').

'malalignment' formed in English by combining the negative prefix 'mal-' with 'alignment' (from Middle French 'alignement'); the construction mirrors other English formations using 'mal-' + noun to indicate 'bad' or 'wrong' version of that noun.

Initially it simply conveyed the sense of 'bad or incorrect alignment'; over time it has remained a technical term used in medicine, dentistry, engineering, and mechanics to denote specific kinds of improper alignment.