Nancy Caruana was born in Żurrieq on the 15th April 1964. Following her education at Żurrieq primary and secondary schools, as well as the New Lyceum in Msida, she commenced her career within the Public Service in 1982, starting off as a typist at the Examinations Department. Since then, she has made her way up the career ladder progressively.

In 1994, Ms Caruana moved to the VAT Department taking up the post of a VAT Inspector. She was then entrusted with the role of Central Liaison Officer and was responsible for the VAT Exchange of Information (VIES) on Administrative Cooperation between EU Members States. She was also the Competent Authority for the Recovery of Taxes and a Member of the Public Finance Sectoral Committee for the Euro Changeover.

The Senior Principal examination in 2009 was a turning point in Ms Caruana's career, as soon after she was promoted to Assistant Director at the Government Property Department, responsible for Enforcement Issues. In 2010, Ms Caruana was appointed Director Finance and Administration within the same Department, this time responsible for the HR Department, IT, Procurement and Finance, as well as the overall administration of the Department.

In 2014 she was appointed Director Tourism within the Ministry for Tourism where she played a significant role in the HR aspect. Later in 2014, Ms Caruana was promoted to Permanent Secretary within the Ministry for the Economy, Investment and Small Business. 

In November 2020 this Ministry was redesignated as the Ministry for the Economy and Industry.  

In April 2022 Ms Caruana was appointed Permanent Secretary within the Ministry for Inclusion, Voluntary Organisations and Consumer Rights.

In January 2024, she retained her responsibility for the same Ministry this time for Inclusion and the Voluntary Sector.