Since the 2015 edition, The Mdina Cathedral        Contemporary Art Biennale under the artistic direction of Giuseppe Schembri Bonaci, has taken a radically new approach, evolving from the first exhibition, 'Contemporary Sacred Art in Malta' held in 1994, and the subsequent exhibitions entitled 'Contemporary Christian Art', which took place in 1996, 1998, 2000, 2002 and 2005, as well as other comparable earlier contemporary art exhibitions organised in Malta in the years leading up to 1994.

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The 1994 event ambitiously underlined the idea of museums as "depositories housing the results of cultural achievements attained by man's will-power extending itself in all directions that emerge from human intelligence". The 1996 Biennale concentrated on creating "a further development of the Sacred more closely linked with a definite characteristic of our cultural background". Constant Dialogue was the central theme  of the 1998 event: "The widespread evaluation of the constant dialogue between the artist and the world around him". For obvious reasons the 2000 exhibition focussed on "the end of the present Millennium ... and the long stretch of innumerable decades and revolving centuries of Christian existence". 2002 and 2005 defined sacred, or spiritual, art as the summit of religious art and emphasised its connection with the artist's "noble ministry".

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The 2015 Biennale expanded upon the various parameters from earlier years. It declared all art to be spiritual, in the sense that creative depiction, actions and events, through their intrinsic character, reflect the individual's relation with reality, and with his or her own existence. Hence such creative acts are necessarily spiritual, independent of their ostensible devoutness, independent of a faith or lack of faith, independent of their allegiance to any particular faith, or to none.

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In the second edition, 2017-18, the APS Mdina Biennale explored the multiple manifestations of Mediterranean identity as visualised by past and contemporary art. Artists created site-specific works that investigated the theme and the permanent collection of the Mdina Cathedral Museum.

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The 2020 edition of the APS Mdina Biennale centred on the environmental crises affecting the world today. The theme - Regaining a Paradise Lost: The Role of the Arts - was devised to provoke artists and audiences to think about the purpose of art to our contemporary context which is immersed in planetary destruction and neoliberal exploitation. Artists had to propose projects that engaged with digital media so as to investigate the possibility of more sustainable methods of artistic production.