Kuala Lumpur: Malaysian Prime Minister Mahathir Mohamad described Jews as "hook-nosed" on Tuesday and blamed them for creating the troubles in the Middle East.

Mahathir, who at 93 became the world's oldest head of government after starting his second stint as Prime Minister in May, has for decades been accused of anti-Semitism for his attacks against Jews, whom he has accused of perpetrating a humanitarian crisis in the Palestinian territories.

Malaysian Prime Minister Mahathir Mohamad has not made his anti-Jewish sentiments a secret. Credit:AP

"If you are going to be truthful, the problem in the Middle East began with the creation of Israel. That is the truth. But I cannot say that," he said in an interview on BBC's Hard Talk on Tuesday.

Calling Israelis "special", Mahathir, leader of a Muslim-majority country, challenged historical accounts that six million Jews were killed in the Holocaust, arguing that the figure was four million.