Berdymukhammedov was the grandson of a distinguished local schoolteacher. In 1979 he graduated from the dental faculty of the Turkmen State Medical Institute and started work as a dentist in an Ashgabat clinic. By 1987 he had gradually increased his responsibilities and moved up professionally. He then studied therapeutic dentistry in Moscow for three years, returning to Ashgabat in 1990 to a teaching post at the Turkmen Medical Institute. In 1995 he moved to the Ministry of Health. Two years later he was appointed minister of health, and in April 2001 he became deputy prime minister responsible for education, science, and health.

Following the Dec. 21, 2006, death of Turkmen President Saparmurad Niyazov, Berdymukhammedov was named acting president by Turkmenistan's Security Council. The appointment surprised many in the international community as well as in the country itself. There was some speculation that the powerful Turkmen security service was more comfortable with a person widely perceived as politically weak. According to a recurring rumour in the Turkmen exile community, Berdymukhammedov was the illegitimate son of Niyazov. Such a relationship was possible given their age difference but was still considered unlikely.

On Feb. 11, 2007, Berdymukhammedov was elected president after receiving nearly 90 percent of the votes cast. After he took office, the Turkmen exile community and many citizens hoped for a relaxation of the tight control exercised by Niyazov. There were some improvements: Berdymukhammedov restored the pensions abolished by his predecessor, eased restrictions on travel abroad, and reinstituted the 10th year of basic education that had been dropped on Niyazov's order. However, during his first year in office there was little sign that Berdymukhammedov would implement genuine political and economic reform that would lead to democratization of the country. By late 2007, observers had noted that he was having some of the portraits of Niyazov, which were such a striking feature of the Ashgabat cityscape, replaced with portraits of himself, leading to speculation that the new president was imitating his predecessor and launching his own personality cult. In addition, Berdymukhammedov continued his predecessor's grandiose construction projects, including one to build a new seaport and airport for the city of Turkmenbashi on the Caspian Sea.