<?xml version="1.0" encoding="us-ascii" standalone="yes"?>
<!-- DFIN ActiveDisclosure(SM) XBRL Linkbase Document - http://www.dfinsolutions.com/ -->
<!-- Creation Date      : 2020-05-11T05:21:05.4692046+00:00 -->
<!-- Version            : 5.0.1.385 -->
<!-- Package ID         : 5de6d06138e84209ae3dfcad6bb9226b -->
<!-- Copyright (c) 2020 Donnelley Financial Solutions, Inc. All Rights Reserved. -->
<link:linkbase xmlns:link="http://www.xbrl.org/2003/linkbase" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/role/TemplateLink" xlink:href="mpw-20200331.xsd#TemplateLink" xlink:type="simple" />
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DocumentDocumentAndEntityInformation" xlink:href="mpw-20200331.xsd#Role_DocumentDocumentAndEntityInformation" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DocumentDocumentAndEntityInformation">
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentTransitionReport" xlink:type="locator" xlink:label="dei_DocumentTransitionReport" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentQuarterlyReport" xlink:type="locator" xlink:label="dei_DocumentQuarterlyReport" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityIncorporationStateCountryCode" xlink:type="locator" xlink:label="dei_EntityIncorporationStateCountryCode" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_LocalPhoneNumber" xlink:type="locator" xlink:label="dei_LocalPhoneNumber" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_CityAreaCode" xlink:type="locator" xlink:label="dei_CityAreaCode" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityAddressPostalZipCode" xlink:type="locator" xlink:label="dei_EntityAddressPostalZipCode" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityAddressStateOrProvince" xlink:type="locator" xlink:label="dei_EntityAddressStateOrProvince" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityAddressCityOrTown" xlink:type="locator" xlink:label="dei_EntityAddressCityOrTown" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityAddressAddressLine2" xlink:type="locator" xlink:label="dei_EntityAddressAddressLine2" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityAddressAddressLine1" xlink:type="locator" xlink:label="dei_EntityAddressAddressLine1" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityTaxIdentificationNumber" xlink:type="locator" xlink:label="dei_EntityTaxIdentificationNumber" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityFileNumber" xlink:type="locator" xlink:label="dei_EntityFileNumber" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityShellCompany" xlink:type="locator" xlink:label="dei_EntityShellCompany" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_SecurityExchangeName" xlink:type="locator" xlink:label="dei_SecurityExchangeName" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_Security12bTitle" xlink:type="locator" xlink:label="dei_Security12bTitle" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityCommonStockSharesOutstanding" xlink:type="locator" xlink:label="dei_EntityCommonStockSharesOutstanding" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityEmergingGrowthCompany" xlink:type="locator" xlink:label="dei_EntityEmergingGrowthCompany" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntitySmallBusiness" xlink:type="locator" xlink:label="dei_EntitySmallBusiness" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityFilerCategory" xlink:type="locator" xlink:label="dei_EntityFilerCategory" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityInteractiveDataCurrent" xlink:type="locator" xlink:label="dei_EntityInteractiveDataCurrent" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityCurrentReportingStatus" xlink:type="locator" xlink:label="dei_EntityCurrentReportingStatus" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_CurrentFiscalYearEndDate" xlink:type="locator" xlink:label="dei_CurrentFiscalYearEndDate" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityCentralIndexKey" xlink:type="locator" xlink:label="dei_EntityCentralIndexKey" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_EntityRegistrantName" xlink:type="locator" xlink:label="dei_EntityRegistrantName" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_TradingSymbol" xlink:type="locator" xlink:label="dei_TradingSymbol" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentFiscalPeriodFocus" xlink:type="locator" xlink:label="dei_DocumentFiscalPeriodFocus" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentFiscalYearFocus" xlink:type="locator" xlink:label="dei_DocumentFiscalYearFocus" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentPeriodEndDate" xlink:type="locator" xlink:label="dei_DocumentPeriodEndDate" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_AmendmentFlag" xlink:type="locator" xlink:label="dei_AmendmentFlag" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentType" xlink:type="locator" xlink:label="dei_DocumentType" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentInformationLineItems" xlink:type="locator" xlink:label="dei_DocumentInformationLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_DocumentInformationTable" xlink:type="locator" xlink:label="dei_DocumentInformationTable" />
    <link:loc xlink:href="https://xbrl.sec.gov/dei/2019/dei-2019-01-31.xsd#dei_CoverAbstract" xlink:type="locator" xlink:label="dei_CoverAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_CoverAbstract" xlink:to="dei_DocumentInformationTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationTable" xlink:to="dei_DocumentInformationLineItems" order="10560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentType" order="10570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_AmendmentFlag" order="10610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentPeriodEndDate" order="10650.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentFiscalYearFocus" order="10690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentFiscalPeriodFocus" order="10730.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_TradingSymbol" order="10770.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityRegistrantName" order="10810.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityCentralIndexKey" order="10850.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_CurrentFiscalYearEndDate" order="10890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityCurrentReportingStatus" order="10930.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityInteractiveDataCurrent" order="10970.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityFilerCategory" order="11010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntitySmallBusiness" order="11050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityEmergingGrowthCompany" order="11090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityCommonStockSharesOutstanding" order="11130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_Security12bTitle" order="11170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_SecurityExchangeName" order="11210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityShellCompany" order="11250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityFileNumber" order="11290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityTaxIdentificationNumber" order="11330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressAddressLine1" order="11370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressAddressLine2" order="11410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressCityOrTown" order="11450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressStateOrProvince" order="11490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityAddressPostalZipCode" order="11530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_CityAreaCode" order="11570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_LocalPhoneNumber" order="11610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_EntityIncorporationStateCountryCode" order="11650.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentQuarterlyReport" order="11690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="dei_DocumentInformationLineItems" xlink:to="dei_DocumentTransitionReport" order="11730.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedBalanceSheets" xlink:href="mpw-20200331.xsd#Role_StatementCondensedConsolidatedBalanceSheets" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedBalanceSheets">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LimitedPartnersCapitalAccount" xlink:type="locator" xlink:label="us-gaap_LimitedPartnersCapitalAccount" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquity" xlink:type="locator" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MinorityInterest" xlink:type="locator" xlink:label="us-gaap_MinorityInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquity" xlink:type="locator" xlink:label="us-gaap_StockholdersEquity" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_TreasuryStockValue" xlink:type="locator" xlink:label="us-gaap_TreasuryStockValue" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" xlink:type="locator" xlink:label="us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RetainedEarningsAccumulatedDeficit" xlink:type="locator" xlink:label="us-gaap_RetainedEarningsAccumulatedDeficit" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AdditionalPaidInCapitalCommonStock" xlink:type="locator" xlink:label="us-gaap_AdditionalPaidInCapitalCommonStock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LimitedPartnersCapitalAccountAbstract" xlink:type="locator" xlink:label="us-gaap_LimitedPartnersCapitalAccountAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeneralPartnersCapitalAccount" xlink:type="locator" xlink:label="us-gaap_GeneralPartnersCapitalAccount" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockValue" xlink:type="locator" xlink:label="us-gaap_CommonStockValue" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockValue" xlink:type="locator" xlink:label="us-gaap_PreferredStockValue" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Liabilities" xlink:type="locator" xlink:label="us-gaap_Liabilities" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PayableDueToParentCompany" xlink:type="locator" xlink:label="mpw_PayableDueToParentCompany" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ObligationsToTenantsAndOtherLeaseLiabilities" xlink:type="locator" xlink:label="mpw_ObligationsToTenantsAndOtherLeaseLiabilities" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ContractWithCustomerLiability" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiability" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesCurrentAndNoncurrent" xlink:type="locator" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrentAndNoncurrent" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebt" xlink:type="locator" xlink:label="us-gaap_LongTermDebt" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesAbstract" xlink:type="locator" xlink:label="us-gaap_LiabilitiesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:type="locator" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Assets" xlink:type="locator" xlink:label="us-gaap_Assets" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherAssets" xlink:type="locator" xlink:label="us-gaap_OtherAssets" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_AcquisitionLoansAndOtherLoans" xlink:type="locator" xlink:label="mpw_AcquisitionLoansAndOtherLoans" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityMethodInvestments" xlink:type="locator" xlink:label="us-gaap_EquityMethodInvestments" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_StraightLineRentReceivable" xlink:type="locator" xlink:label="mpw_StraightLineRentReceivable" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_InterestAndRentReceivable" xlink:type="locator" xlink:label="mpw_InterestAndRentReceivable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NetInvestmentInRealEstateAssets" xlink:type="locator" xlink:label="mpw_NetInvestmentInRealEstateAssets" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_RealEstateAccumulatedDepreciationAndAmortization" xlink:type="locator" xlink:label="mpw_RealEstateAccumulatedDepreciationAndAmortization" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_GrossInvestmentInRealEstateAssets" xlink:type="locator" xlink:label="mpw_GrossInvestmentInRealEstateAssets" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MortgageLoansOnRealEstateCommercialAndConsumerNet" xlink:type="locator" xlink:label="us-gaap_MortgageLoansOnRealEstateCommercialAndConsumerNet" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetInvestmentInLease" xlink:type="locator" xlink:label="us-gaap_NetInvestmentInLease" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LandBuildingsAndImprovementsIntangibleLeaseAssetsAndOther" xlink:type="locator" xlink:label="mpw_LandBuildingsAndImprovementsIntangibleLeaseAssetsAndOther" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_RealEstateAssetsAbstract" xlink:type="locator" xlink:label="mpw_RealEstateAssetsAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AssetsAbstract" xlink:type="locator" xlink:label="us-gaap_AssetsAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LTIPUnitsMember" xlink:type="locator" xlink:label="mpw_LTIPUnitsMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_CommonUnitsMember" xlink:type="locator" xlink:label="mpw_CommonUnitsMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeneralPartnerMember" xlink:type="locator" xlink:label="us-gaap_GeneralPartnerMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:type="locator" xlink:label="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" xlink:type="locator" xlink:label="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfFinancialPositionAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_StatementTable" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" xlink:to="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="us-gaap_GeneralPartnerMember" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="mpw_CommonUnitsMember" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="mpw_LTIPUnitsMember" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10310.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AssetsAbstract" order="10510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="mpw_RealEstateAssetsAbstract" order="10590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_RealEstateAssetsAbstract" xlink:to="mpw_LandBuildingsAndImprovementsIntangibleLeaseAssetsAndOther" order="10670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_RealEstateAssetsAbstract" xlink:to="us-gaap_NetInvestmentInLease" order="10710.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_RealEstateAssetsAbstract" xlink:to="us-gaap_MortgageLoansOnRealEstateCommercialAndConsumerNet" order="10750.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_RealEstateAssetsAbstract" xlink:to="mpw_GrossInvestmentInRealEstateAssets" order="10790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_RealEstateAssetsAbstract" xlink:to="mpw_RealEstateAccumulatedDepreciationAndAmortization" order="10830.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_RealEstateAssetsAbstract" xlink:to="mpw_NetInvestmentInRealEstateAssets" order="10870.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue" order="10910.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="mpw_InterestAndRentReceivable" order="10950.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="mpw_StraightLineRentReceivable" order="10990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_EquityMethodInvestments" order="11030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="mpw_AcquisitionLoansAndOtherLoans" order="11070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_OtherAssets" order="11110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_Assets" order="11150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LiabilitiesAndStockholdersEquityAbstract" order="11190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesAbstract" order="11270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAbstract" xlink:to="us-gaap_LongTermDebt" order="11350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAbstract" xlink:to="us-gaap_AccountsPayableAndAccruedLiabilitiesCurrentAndNoncurrent" order="11390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAbstract" xlink:to="us-gaap_ContractWithCustomerLiability" order="11430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAbstract" xlink:to="mpw_ObligationsToTenantsAndOtherLeaseLiabilities" order="11470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAbstract" xlink:to="mpw_PayableDueToParentCompany" order="11510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAbstract" xlink:to="us-gaap_Liabilities" order="11550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" order="11590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_PreferredStockValue" order="11670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_CommonStockValue" order="11710.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_GeneralPartnersCapitalAccount" order="11750.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_LimitedPartnersCapitalAccountAbstract" order="11790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_AdditionalPaidInCapitalCommonStock" order="11870.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_RetainedEarningsAccumulatedDeficit" order="11910.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" order="11950.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_TreasuryStockValue" order="11990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_StockholdersEquity" order="12030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_MinorityInterest" order="12070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterestAbstract" xlink:to="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" order="12110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesAndStockholdersEquity" order="12150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LimitedPartnersCapitalAccountAbstract" xlink:to="us-gaap_LimitedPartnersCapitalAccount" order="13500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedBalanceSheetsParenthetical" xlink:href="mpw-20200331.xsd#Role_StatementCondensedConsolidatedBalanceSheetsParenthetical" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedBalanceSheetsParenthetical">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LimitedPartnersCapitalAccountUnitsOutstanding" xlink:type="locator" xlink:label="us-gaap_LimitedPartnersCapitalAccountUnitsOutstanding" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LimitedPartnersCapitalAccountUnitsIssued" xlink:type="locator" xlink:label="us-gaap_LimitedPartnersCapitalAccountUnitsIssued" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonUnitOutstanding" xlink:type="locator" xlink:label="us-gaap_CommonUnitOutstanding" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonUnitIssued" xlink:type="locator" xlink:label="us-gaap_CommonUnitIssued" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeneralPartnersCapitalAccountUnitsOutstanding" xlink:type="locator" xlink:label="us-gaap_GeneralPartnersCapitalAccountUnitsOutstanding" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeneralPartnersCapitalAccountUnitsIssued" xlink:type="locator" xlink:label="us-gaap_GeneralPartnersCapitalAccountUnitsIssued" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesOutstanding" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesIssued" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesIssued" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockSharesAuthorized" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesAuthorized" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockParOrStatedValuePerShare" xlink:type="locator" xlink:label="us-gaap_CommonStockParOrStatedValuePerShare" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_PreferredStockSharesOutstanding" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockSharesAuthorized" xlink:type="locator" xlink:label="us-gaap_PreferredStockSharesAuthorized" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockParOrStatedValuePerShare" xlink:type="locator" xlink:label="us-gaap_PreferredStockParOrStatedValuePerShare" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LTIPUnitsMember" xlink:type="locator" xlink:label="mpw_LTIPUnitsMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_CommonUnitsMember" xlink:type="locator" xlink:label="mpw_CommonUnitsMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeneralPartnerMember" xlink:type="locator" xlink:label="us-gaap_GeneralPartnerMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:type="locator" xlink:label="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" xlink:type="locator" xlink:label="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfFinancialPositionAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_StatementTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" xlink:to="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="us-gaap_GeneralPartnerMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="mpw_CommonUnitsMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="mpw_LTIPUnitsMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockParOrStatedValuePerShare" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockSharesAuthorized" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PreferredStockSharesOutstanding" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockParOrStatedValuePerShare" order="10490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesAuthorized" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesIssued" order="10570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesOutstanding" order="10610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_GeneralPartnersCapitalAccountUnitsIssued" order="10680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_GeneralPartnersCapitalAccountUnitsOutstanding" order="10720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonUnitIssued" order="10760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonUnitOutstanding" order="10800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LimitedPartnersCapitalAccountUnitsIssued" order="10840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LimitedPartnersCapitalAccountUnitsOutstanding" order="10880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfNetIncomeUnaudited" xlink:href="mpw-20200331.xsd#Role_StatementCondensedConsolidatedStatementsOfNetIncomeUnaudited" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfNetIncomeUnaudited">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockDividendsPerShareDeclared" xlink:type="locator" xlink:label="us-gaap_CommonStockDividendsPerShareDeclared" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareBasicAndDiluted" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareBasicAndDiluted" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareBasicAndDilutedAbstract" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareBasicAndDilutedAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetIncomeLoss" xlink:type="locator" xlink:label="us-gaap_NetIncomeLoss" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProfitLoss" xlink:type="locator" xlink:label="us-gaap_ProfitLoss" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_IncomeTaxExpenseBenefit" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NonoperatingIncomeExpense" xlink:type="locator" xlink:label="us-gaap_NonoperatingIncomeExpense" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherNonoperatingIncomeExpense" xlink:type="locator" xlink:label="us-gaap_OtherNonoperatingIncomeExpense" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_UnutilizedFinancingFees" xlink:type="locator" xlink:label="mpw_UnutilizedFinancingFees" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeLossFromEquityMethodInvestments" xlink:type="locator" xlink:label="us-gaap_IncomeLossFromEquityMethodInvestments" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AssetImpairmentCharges" xlink:type="locator" xlink:label="us-gaap_AssetImpairmentCharges" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GainsLossesOnSalesOfInvestmentRealEstate" xlink:type="locator" xlink:label="us-gaap_GainsLossesOnSalesOfInvestmentRealEstate" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NonoperatingIncomeExpenseAbstract" xlink:type="locator" xlink:label="us-gaap_NonoperatingIncomeExpenseAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CostsAndExpenses" xlink:type="locator" xlink:label="us-gaap_CostsAndExpenses" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeneralAndAdministrativeExpense" xlink:type="locator" xlink:label="us-gaap_GeneralAndAdministrativeExpense" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_CostsOfLeasedAndRentedPropertyOrEquipment" xlink:type="locator" xlink:label="mpw_CostsOfLeasedAndRentedPropertyOrEquipment" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DepreciationAndAmortization" xlink:type="locator" xlink:label="us-gaap_DepreciationAndAmortization" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InterestExpense" xlink:type="locator" xlink:label="us-gaap_InterestExpense" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CostsAndExpensesAbstract" xlink:type="locator" xlink:label="us-gaap_CostsAndExpensesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_Revenues" xlink:type="locator" xlink:label="us-gaap_Revenues" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InterestAndOtherIncome" xlink:type="locator" xlink:label="us-gaap_InterestAndOtherIncome" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DirectFinancingLeaseRevenue" xlink:type="locator" xlink:label="us-gaap_DirectFinancingLeaseRevenue" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_StraightLineRentRevenueNetOfWriteOffs" xlink:type="locator" xlink:label="mpw_StraightLineRentRevenueNetOfWriteOffs" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_RentBilled" xlink:type="locator" xlink:label="mpw_RentBilled" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RevenuesAbstract" xlink:type="locator" xlink:label="us-gaap_RevenuesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncomeStatementAbstract" xlink:type="locator" xlink:label="us-gaap_IncomeStatementAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_StatementTable" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_RevenuesAbstract" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenuesAbstract" xlink:to="mpw_RentBilled" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenuesAbstract" xlink:to="mpw_StraightLineRentRevenueNetOfWriteOffs" order="10430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenuesAbstract" xlink:to="us-gaap_DirectFinancingLeaseRevenue" order="10470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenuesAbstract" xlink:to="us-gaap_InterestAndOtherIncome" order="10510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenuesAbstract" xlink:to="us-gaap_Revenues" order="10550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CostsAndExpensesAbstract" order="10590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_InterestExpense" order="10670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_DepreciationAndAmortization" order="10710.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="mpw_CostsOfLeasedAndRentedPropertyOrEquipment" order="10750.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_GeneralAndAdministrativeExpense" order="10790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostsAndExpensesAbstract" xlink:to="us-gaap_CostsAndExpenses" order="10830.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NonoperatingIncomeExpenseAbstract" order="10870.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonoperatingIncomeExpenseAbstract" xlink:to="us-gaap_GainsLossesOnSalesOfInvestmentRealEstate" order="10950.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonoperatingIncomeExpenseAbstract" xlink:to="us-gaap_AssetImpairmentCharges" order="10990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonoperatingIncomeExpenseAbstract" xlink:to="us-gaap_IncomeLossFromEquityMethodInvestments" order="11030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonoperatingIncomeExpenseAbstract" xlink:to="mpw_UnutilizedFinancingFees" order="11070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonoperatingIncomeExpenseAbstract" xlink:to="us-gaap_OtherNonoperatingIncomeExpense" order="11110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonoperatingIncomeExpenseAbstract" xlink:to="us-gaap_NonoperatingIncomeExpense" order="11150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" order="11190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="11230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ProfitLoss" order="11270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" order="11310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetIncomeLoss" order="11350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_EarningsPerShareBasicAndDilutedAbstract" order="11390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicAndDilutedAbstract" xlink:to="us-gaap_EarningsPerShareBasicAndDiluted" order="11470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" order="11510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" order="11550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockDividendsPerShareDeclared" order="11590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfComprehensiveIncomeUnaudited" xlink:href="mpw-20200331.xsd#Role_StatementCondensedConsolidatedStatementsOfComprehensiveIncomeUnaudited" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfComprehensiveIncomeUnaudited">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ComprehensiveIncomeNetOfTax" xlink:type="locator" xlink:label="us-gaap_ComprehensiveIncomeNetOfTax" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationGainLossArisingDuringPeriodNetOfTax" xlink:type="locator" xlink:label="us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationGainLossArisingDuringPeriodNetOfTax" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_OtherComprehensiveIncomeUnrealizedGainLossOnDerivativesNetOfTax" xlink:type="locator" xlink:label="mpw_OtherComprehensiveIncomeUnrealizedGainLossOnDerivativesNetOfTax" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherComprehensiveIncomeLossNetOfTaxPeriodIncreaseDecreaseAbstract" xlink:type="locator" xlink:label="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPeriodIncreaseDecreaseAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProfitLoss" xlink:type="locator" xlink:label="us-gaap_ProfitLoss" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfIncomeAndComprehensiveIncomeAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfIncomeAndComprehensiveIncomeAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfIncomeAndComprehensiveIncomeAbstract" xlink:to="us-gaap_StatementTable" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ProfitLoss" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPeriodIncreaseDecreaseAbstract" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPeriodIncreaseDecreaseAbstract" xlink:to="mpw_OtherComprehensiveIncomeUnrealizedGainLossOnDerivativesNetOfTax" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPeriodIncreaseDecreaseAbstract" xlink:to="us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationGainLossArisingDuringPeriodNetOfTax" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OtherComprehensiveIncomeLossNetOfTaxPeriodIncreaseDecreaseAbstract" xlink:to="us-gaap_ComprehensiveIncomeNetOfTaxIncludingPortionAttributableToNoncontrollingInterest" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ComprehensiveIncomeNetOfTaxAttributableToNoncontrollingInterest" order="10420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ComprehensiveIncomeNetOfTax" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfEquityCapital" xlink:href="mpw-20200331.xsd#Role_StatementCondensedConsolidatedStatementsOfEquityCapital" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfEquityCapital">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharesOutstanding" xlink:type="locator" xlink:label="us-gaap_SharesOutstanding_li0l2" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_li0l2" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DividendsCommonStockCash" xlink:type="locator" xlink:label="us-gaap_DividendsCommonStockCash" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesNewIssues" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesNewIssues" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueNewIssues" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodValueNewIssues" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders" xlink:type="locator" xlink:label="us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_StockIssuedDuringPeriodSharesStockVestingAndAmortizationOfStockBasedCompensation" xlink:type="locator" xlink:label="mpw_StockIssuedDuringPeriodSharesStockVestingAndAmortizationOfStockBasedCompensation" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_StockIssuedDuringPeriodValueStockVestingAndAmortizationOfStockBasedCompensation" xlink:type="locator" xlink:label="mpw_StockIssuedDuringPeriodValueStockVestingAndAmortizationOfStockBasedCompensation" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationGainLossArisingDuringPeriodNetOfTax" xlink:type="locator" xlink:label="us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationGainLossArisingDuringPeriodNetOfTax" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_OtherComprehensiveIncomeUnrealizedGainLossOnDerivativesNetOfTax" xlink:type="locator" xlink:label="mpw_OtherComprehensiveIncomeUnrealizedGainLossOnDerivativesNetOfTax" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CumulativeEffectOnRetainedEarningsNetOfTax1" xlink:type="locator" xlink:label="us-gaap_CumulativeEffectOnRetainedEarningsNetOfTax1" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProfitLoss" xlink:type="locator" xlink:label="us-gaap_ProfitLoss" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SharesOutstanding" xlink:type="locator" xlink:label="us-gaap_SharesOutstanding" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LongTermIncentivePlanMember" xlink:type="locator" xlink:label="mpw_LongTermIncentivePlanMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LimitedPartnerMember" xlink:type="locator" xlink:label="us-gaap_LimitedPartnerMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeneralPartnerMember" xlink:type="locator" xlink:label="us-gaap_GeneralPartnerMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:type="locator" xlink:label="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" xlink:type="locator" xlink:label="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NoncontrollingInterestMember" xlink:type="locator" xlink:label="us-gaap_NoncontrollingInterestMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_TreasuryStockMember" xlink:type="locator" xlink:label="us-gaap_TreasuryStockMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeMember" xlink:type="locator" xlink:label="us-gaap_AccumulatedOtherComprehensiveIncomeMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RetainedEarningsMember" xlink:type="locator" xlink:label="us-gaap_RetainedEarningsMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AdditionalPaidInCapitalMember" xlink:type="locator" xlink:label="us-gaap_AdditionalPaidInCapitalMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PreferredStockMember" xlink:type="locator" xlink:label="us-gaap_PreferredStockMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfStockholdersEquityAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfStockholdersEquityAbstract" xlink:to="us-gaap_StatementTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_PreferredStockMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_AdditionalPaidInCapitalMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_RetainedEarningsMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_AccumulatedOtherComprehensiveIncomeMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_TreasuryStockMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_NoncontrollingInterestMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" xlink:to="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" order="10720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="us-gaap_GeneralPartnerMember" order="10740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="us-gaap_LimitedPartnerMember" order="10780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="mpw_LongTermIncentivePlanMember" order="10940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="11560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest" order="11570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SharesOutstanding" order="11590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ProfitLoss" order="11790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CumulativeEffectOnRetainedEarningsNetOfTax1" order="12010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="mpw_OtherComprehensiveIncomeUnrealizedGainLossOnDerivativesNetOfTax" order="12230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationGainLossArisingDuringPeriodNetOfTax" order="12450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="mpw_StockIssuedDuringPeriodValueStockVestingAndAmortizationOfStockBasedCompensation" order="12670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="mpw_StockIssuedDuringPeriodSharesStockVestingAndAmortizationOfStockBasedCompensation" order="12730.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_MinorityInterestDecreaseFromDistributionsToNoncontrollingInterestHolders" order="12890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueNewIssues" order="13110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesNewIssues" order="13170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_DividendsCommonStockCash" order="13330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquityIncludingPortionAttributableToNoncontrollingInterest_li0l2" order="13550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SharesOutstanding_li0l2" order="13570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfEquityCapitalParenthetical" xlink:href="mpw-20200331.xsd#Role_StatementCondensedConsolidatedStatementsOfEquityCapitalParenthetical" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfEquityCapitalParenthetical">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockDividendsPerShareDeclared" xlink:type="locator" xlink:label="us-gaap_CommonStockDividendsPerShareDeclared" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LimitedPartnerMember" xlink:type="locator" xlink:label="us-gaap_LimitedPartnerMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeneralPartnerMember" xlink:type="locator" xlink:label="us-gaap_GeneralPartnerMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:type="locator" xlink:label="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" xlink:type="locator" xlink:label="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RetainedEarningsMember" xlink:type="locator" xlink:label="us-gaap_RetainedEarningsMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfStockholdersEquityAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfStockholdersEquityAbstract" xlink:to="us-gaap_StatementTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_RetainedEarningsMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountAxis" xlink:to="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="us-gaap_GeneralPartnerMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PartnerTypeOfPartnersCapitalAccountNameDomain" xlink:to="us-gaap_LimitedPartnerMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockDividendsPerShareDeclared" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfCashFlowsUnaudited" xlink:href="mpw-20200331.xsd#Role_StatementCondensedConsolidatedStatementsOfCashFlowsUnaudited" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/StatementCondensedConsolidatedStatementsOfCashFlowsUnaudited">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RestrictedCashAndCashEquivalentsAssetStatementOfFinancialPositionExtensibleList" xlink:type="locator" xlink:label="us-gaap_RestrictedCashAndCashEquivalentsAssetStatementOfFinancialPositionExtensibleList_li0l2" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RestrictedCashAndCashEquivalents" xlink:type="locator" xlink:label="us-gaap_RestrictedCashAndCashEquivalents_li0l2" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue_li0l2" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RestrictedCashAndCashEquivalentsAssetStatementOfFinancialPositionExtensibleList" xlink:type="locator" xlink:label="us-gaap_RestrictedCashAndCashEquivalentsAssetStatementOfFinancialPositionExtensibleList" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RestrictedCashAndCashEquivalents" xlink:type="locator" xlink:label="us-gaap_RestrictedCashAndCashEquivalents" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DividendsPayableCurrentAndNoncurrent" xlink:type="locator" xlink:label="us-gaap_DividendsPayableCurrentAndNoncurrent" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_SupplementalScheduleOfNonCashFinancingActivitiesAbstract" xlink:type="locator" xlink:label="mpw_SupplementalScheduleOfNonCashFinancingActivitiesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InterestPaid" xlink:type="locator" xlink:label="us-gaap_InterestPaid" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations_li0l2" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:type="locator" xlink:label="us-gaap_EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseExcludingExchangeRateEffect" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseExcludingExchangeRateEffect" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivities" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromPaymentsForOtherFinancingActivities" xlink:type="locator" xlink:label="us-gaap_ProceedsFromPaymentsForOtherFinancingActivities" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromIssuanceOfCommonStock" xlink:type="locator" xlink:label="us-gaap_ProceedsFromIssuanceOfCommonStock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromIssuanceOfCommonLimitedPartnersUnits" xlink:type="locator" xlink:label="us-gaap_ProceedsFromIssuanceOfCommonLimitedPartnersUnits" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PaymentsForProceedsFromLeaseDepositsAndOtherObligationsToTenants" xlink:type="locator" xlink:label="mpw_PaymentsForProceedsFromLeaseDepositsAndOtherObligationsToTenants" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PaymentsOfOrdinaryDividends" xlink:type="locator" xlink:label="us-gaap_PaymentsOfOrdinaryDividends" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromRepaymentsOfLinesOfCredit" xlink:type="locator" xlink:label="us-gaap_ProceedsFromRepaymentsOfLinesOfCredit" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromIssuanceOfLongTermDebt" xlink:type="locator" xlink:label="us-gaap_ProceedsFromIssuanceOfLongTermDebt" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivities" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PaymentForProceedsFromConstructionInProgressEquipmentAndOther" xlink:type="locator" xlink:label="mpw_PaymentForProceedsFromConstructionInProgressEquipmentAndOther" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PaymentsToAcquireLoansReceivable" xlink:type="locator" xlink:label="us-gaap_PaymentsToAcquireLoansReceivable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromCollectionOfLoansReceivable" xlink:type="locator" xlink:label="us-gaap_ProceedsFromCollectionOfLoansReceivable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromSaleOfProductiveAssets" xlink:type="locator" xlink:label="us-gaap_ProceedsFromSaleOfProductiveAssets" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PaymentsToAcquireRealEstate" xlink:type="locator" xlink:label="us-gaap_PaymentsToAcquireRealEstate" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivities" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_IncreaseDecreaseInInterestAndRentReceivable" xlink:type="locator" xlink:label="mpw_IncreaseDecreaseInInterestAndRentReceivable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherNoncashIncomeExpense" xlink:type="locator" xlink:label="us-gaap_OtherNoncashIncomeExpense" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_UnutilizedFinancingFees" xlink:type="locator" xlink:label="mpw_UnutilizedFinancingFees" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_StraightLineRentAndOtherWriteOffNetOfTax" xlink:type="locator" xlink:label="mpw_StraightLineRentAndOtherWriteOffNetOfTax" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AssetImpairmentCharges" xlink:type="locator" xlink:label="us-gaap_AssetImpairmentCharges" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GainsLossesOnSalesOfInvestmentRealEstate" xlink:type="locator" xlink:label="us-gaap_GainsLossesOnSalesOfInvestmentRealEstate" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensation" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensation" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_StraightLineRentRevenueAndOther" xlink:type="locator" xlink:label="mpw_StraightLineRentRevenueAndOther" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AmortizationOfFinancingCostsAndDiscounts" xlink:type="locator" xlink:label="us-gaap_AmortizationOfFinancingCostsAndDiscounts" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:type="locator" xlink:label="us-gaap_DepreciationDepletionAndAmortization" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProfitLoss" xlink:type="locator" xlink:label="us-gaap_ProfitLoss" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementOfCashFlowsAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfCashFlowsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_StatementTable" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_ProfitLoss" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_DepreciationDepletionAndAmortization" order="10580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AmortizationOfFinancingCostsAndDiscounts" order="10620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="mpw_StraightLineRentRevenueAndOther" order="10660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_ShareBasedCompensation" order="10700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_GainsLossesOnSalesOfInvestmentRealEstate" order="10740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AssetImpairmentCharges" order="10780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="mpw_StraightLineRentAndOtherWriteOffNetOfTax" order="10820.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="mpw_UnutilizedFinancingFees" order="10860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_OtherNoncashIncomeExpense" order="10900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" order="10940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="mpw_IncreaseDecreaseInInterestAndRentReceivable" order="11020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInAccountsPayableAndAccruedLiabilities" order="11060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivities" order="11100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" order="11140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquireRealEstate" order="11220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromSaleOfProductiveAssets" order="11260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromCollectionOfLoansReceivable" order="11300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquireLoansReceivable" order="11340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="mpw_PaymentForProceedsFromConstructionInProgressEquipmentAndOther" order="11380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivities" order="11420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" order="11460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromIssuanceOfLongTermDebt" order="11540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromRepaymentsOfLinesOfCredit" order="11580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_PaymentsOfOrdinaryDividends" order="11620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="mpw_PaymentsForProceedsFromLeaseDepositsAndOtherObligationsToTenants" order="11660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromIssuanceOfCommonLimitedPartnersUnits" order="11700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromIssuanceOfCommonStock" order="11740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromPaymentsForOtherFinancingActivities" order="11780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivities" order="11820.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseExcludingExchangeRateEffect" order="11860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" order="11900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations" order="11940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations_li0l2" order="11980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_InterestPaid" order="12020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="mpw_SupplementalScheduleOfNonCashFinancingActivitiesAbstract" order="12060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_SupplementalScheduleOfNonCashFinancingActivitiesAbstract" xlink:to="us-gaap_DividendsPayableCurrentAndNoncurrent" order="12140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" order="12180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue" order="12260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:to="us-gaap_RestrictedCashAndCashEquivalents" order="12300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:to="us-gaap_RestrictedCashAndCashEquivalentsAssetStatementOfFinancialPositionExtensibleList" order="12340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations" order="12380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue_li0l2" order="12420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:to="us-gaap_RestrictedCashAndCashEquivalents_li0l2" order="12460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:to="us-gaap_RestrictedCashAndCashEquivalentsAssetStatementOfFinancialPositionExtensibleList_li0l2" order="12500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsIncludingDisposalGroupAndDiscontinuedOperations_li0l2" order="12540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureOrganization" xlink:href="mpw-20200331.xsd#Role_DisclosureOrganization" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureOrganization">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsDisclosureTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureSummaryOfSignificantAccountingPolicies" xlink:href="mpw-20200331.xsd#Role_DisclosureSummaryOfSignificantAccountingPolicies" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureSummaryOfSignificantAccountingPolicies">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SignificantAccountingPoliciesTextBlock" xlink:type="locator" xlink:label="us-gaap_SignificantAccountingPoliciesTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_SignificantAccountingPoliciesTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivities" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivities" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivities">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RealEstateDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_RealEstateDisclosureTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RealEstateAbstract" xlink:type="locator" xlink:label="us-gaap_RealEstateAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RealEstateAbstract" xlink:to="us-gaap_RealEstateDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebt" xlink:href="mpw-20200331.xsd#Role_DisclosureDebt" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebt">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebtTextBlock" xlink:type="locator" xlink:label="us-gaap_LongTermDebtTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LongTermDebtTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureCommonStockPartnerSCapital" xlink:href="mpw-20200331.xsd#Role_DisclosureCommonStockPartnerSCapital" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureCommonStockPartnerSCapital">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnersCapitalNotesDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_PartnersCapitalNotesDisclosureTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityAbstract" xlink:type="locator" xlink:label="us-gaap_EquityAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityAbstract" xlink:to="us-gaap_PartnersCapitalNotesDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureStockAwards" xlink:href="mpw-20200331.xsd#Role_DisclosureStockAwards" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureStockAwards">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_DisclosureOfCompensationRelatedCostsShareBasedPaymentsTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureFairValueOfFinancialInstruments" xlink:href="mpw-20200331.xsd#Role_DisclosureFairValueOfFinancialInstruments" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureFairValueOfFinancialInstruments">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueDisclosuresTextBlock" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_FairValueDisclosuresTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureEarningsPerShareUnit" xlink:href="mpw-20200331.xsd#Role_DisclosureEarningsPerShareUnit" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureEarningsPerShareUnit">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareTextBlock" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureContingencies" xlink:href="mpw-20200331.xsd#Role_DisclosureContingencies" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureContingencies">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesPolicies" xlink:href="mpw-20200331.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesPolicies" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesPolicies">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PriorPeriodReclassificationAdjustmentDescription" xlink:type="locator" xlink:label="us-gaap_PriorPeriodReclassificationAdjustmentDescription" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConsolidationPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_ConsolidationPolicyTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ConsolidationPolicyTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_PriorPeriodReclassificationAdjustmentDescription" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesTables" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesTables" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesTables">
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ScheduleOfLoansReceivableTableTextBlock" xlink:type="locator" xlink:label="mpw_ScheduleOfLoansReceivableTableTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DirectFinancingLeaseLeaseIncomeTableTextBlock" xlink:type="locator" xlink:label="us-gaap_DirectFinancingLeaseLeaseIncomeTableTextBlock" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ScheduleOfDevelopmentProjectsTableTextBlock" xlink:type="locator" xlink:label="mpw_ScheduleOfDevelopmentProjectsTableTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RealEstateAbstract" xlink:type="locator" xlink:label="us-gaap_RealEstateAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RealEstateAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RealEstateAbstract" xlink:to="mpw_ScheduleOfDevelopmentProjectsTableTextBlock" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RealEstateAbstract" xlink:to="us-gaap_DirectFinancingLeaseLeaseIncomeTableTextBlock" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RealEstateAbstract" xlink:to="mpw_ScheduleOfLoansReceivableTableTextBlock" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtTables" xlink:href="mpw-20200331.xsd#Role_DisclosureDebtTables" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtTables">
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ContractualObligationFiscalYearMaturityScheduleTableTextBlock" xlink:type="locator" xlink:label="srt_ContractualObligationFiscalYearMaturityScheduleTableTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfDebtTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfDebtTableTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_ScheduleOfDebtTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="srt_ContractualObligationFiscalYearMaturityScheduleTableTextBlock" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsTables" xlink:href="mpw-20200331.xsd#Role_DisclosureFairValueOfFinancialInstrumentsTables" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsTables">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueByBalanceSheetGroupingTextBlock" xlink:type="locator" xlink:label="us-gaap_FairValueByBalanceSheetGroupingTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_FairValueByBalanceSheetGroupingTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureEarningsPerShareUnitTables" xlink:href="mpw-20200331.xsd#Role_DisclosureEarningsPerShareUnitTables" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureEarningsPerShareUnitTables">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfEarningsPerShareBasicAndDilutedTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfEarningsPerShareBasicAndDilutedTableTextBlock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_ScheduleOfEarningsPerShareBasicAndDilutedTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureOrganizationAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureOrganizationAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureOrganizationAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NumberOfCountriesInWhichEntityOperates" xlink:type="locator" xlink:label="us-gaap_NumberOfCountriesInWhichEntityOperates" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NumberOfStatesInWhichEntityOperates" xlink:type="locator" xlink:label="us-gaap_NumberOfStatesInWhichEntityOperates" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfFacilities" xlink:type="locator" xlink:label="mpw_NumberOfFacilities" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="mpw_NumberOfFacilities" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_NumberOfStatesInWhichEntityOperates" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_NumberOfCountriesInWhichEntityOperates" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LoansAndLeasesReceivableAllowance" xlink:type="locator" xlink:label="us-gaap_LoansAndLeasesReceivableAllowance" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingStandardsUpdate201613Member" xlink:type="locator" xlink:label="us-gaap_AccountingStandardsUpdate201613Member" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_TypeOfAdoptionMember" xlink:type="locator" xlink:label="us-gaap_TypeOfAdoptionMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:type="locator" xlink:label="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_StatementTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:to="us-gaap_TypeOfAdoptionMember" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfAdoptionMember" xlink:to="us-gaap_AccountingStandardsUpdate201613Member" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_LoansAndLeasesReceivableAllowance" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesNetAssetsAcquiredDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesNetAssetsAcquiredDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesNetAssetsAcquiredDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedLiabilities" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedLiabilities" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedAssets" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedAssets" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_IntangibleLeaseAssetsMember" xlink:type="locator" xlink:label="mpw_IntangibleLeaseAssetsMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BuildingMember" xlink:type="locator" xlink:label="us-gaap_BuildingMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LandAndLandImprovementsMember" xlink:type="locator" xlink:label="us-gaap_LandAndLandImprovementsMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_OtherAssetsMember" xlink:type="locator" xlink:label="us-gaap_OtherAssetsMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BalanceSheetLocationDomain" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BalanceSheetLocationAxis" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BalanceSheetLocationAxis" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationAxis" xlink:to="us-gaap_BalanceSheetLocationDomain" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="us-gaap_OtherAssetsMember" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" order="10080.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_LandAndLandImprovementsMember" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_BuildingMember" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="mpw_IntangibleLeaseAssetsMember" order="10230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedAssets" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedLiabilities" order="10420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNet" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesNetAssetsAcquiredParentheticalDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesNetAssetsAcquiredParentheticalDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesNetAssetsAcquiredParentheticalDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" xlink:type="locator" xlink:label="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_IntangibleLeaseAssetsMember" xlink:type="locator" xlink:label="mpw_IntangibleLeaseAssetsMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="mpw_IntangibleLeaseAssetsMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_AcquiredFiniteLivedIntangibleAssetsWeightedAverageUsefulLife" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivities2020ActivityAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivities2020ActivityAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivities2020ActivityAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorOperatingLeaseRenewalTerm" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseRenewalTerm" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfLeaseExtensionOptions" xlink:type="locator" xlink:label="mpw_NumberOfLeaseExtensionOptions" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorOperatingLeaseOptionToExtend" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseOptionToExtend" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorOperatingLeaseTermOfContract" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseTermOfContract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorOperatingLeaseExistenceOfOptionToExtend" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseExistenceOfOptionToExtend" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LessorOperatingLeaseInitialFixedTerm" xlink:type="locator" xlink:label="mpw_LessorOperatingLeaseInitialFixedTerm" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfLeasedProperties" xlink:type="locator" xlink:label="mpw_NumberOfLeasedProperties" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationConsiderationTransferred1" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NumberOfBusinessesAcquired" xlink:type="locator" xlink:label="us-gaap_NumberOfBusinessesAcquired" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventMember" xlink:type="locator" xlink:label="us-gaap_SubsequentEventMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventTypeDomain" xlink:type="locator" xlink:label="us-gaap_SubsequentEventTypeDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventTypeAxis" xlink:type="locator" xlink:label="us-gaap_SubsequentEventTypeAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_BMIHealthcareMember" xlink:type="locator" xlink:label="mpw_BMIHealthcareMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:type="locator" xlink:label="srt_NameOfMajorCustomerDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:type="locator" xlink:label="srt_MajorCustomersAxis" />
    <link:loc xlink:href="https://xbrl.sec.gov/country/2017/country-2017-01-31.xsd#country_GB" xlink:type="locator" xlink:label="country_GB" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_SegmentGeographicalDomain" xlink:type="locator" xlink:label="srt_SegmentGeographicalDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_StatementGeographicalAxis" xlink:type="locator" xlink:label="srt_StatementGeographicalAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_AcuteCareHospitalMember" xlink:type="locator" xlink:label="mpw_AcuteCareHospitalMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MajorPropertyClassDomain" xlink:type="locator" xlink:label="us-gaap_MajorPropertyClassDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MajorPropertyClassAxis" xlink:type="locator" xlink:label="us-gaap_MajorPropertyClassAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_MajorPropertyClassAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_MajorPropertyClassAxis" xlink:to="us-gaap_MajorPropertyClassDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_MajorPropertyClassDomain" xlink:to="mpw_AcuteCareHospitalMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_StatementGeographicalAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_StatementGeographicalAxis" xlink:to="srt_SegmentGeographicalDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="country_GB" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_MajorCustomersAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_MajorCustomersAxis" xlink:to="srt_NameOfMajorCustomerDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_BMIHealthcareMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_SubsequentEventTypeAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeAxis" xlink:to="us-gaap_SubsequentEventTypeDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeDomain" xlink:to="us-gaap_SubsequentEventMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_NumberOfBusinessesAcquired" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationConsiderationTransferred1" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfLeasedProperties" order="10430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_LessorOperatingLeaseInitialFixedTerm" order="10470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_LessorOperatingLeaseExistenceOfOptionToExtend" order="10510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_LessorOperatingLeaseTermOfContract" order="10550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_LessorOperatingLeaseOptionToExtend" order="10590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfLeaseExtensionOptions" order="10670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_LessorOperatingLeaseRenewalTerm" order="10710.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivities2019ActivityAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivities2019ActivityAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivities2019ActivityAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorOperatingLeaseTermOfContract" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseTermOfContract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NumberOfBusinessesAcquired" xlink:type="locator" xlink:label="us-gaap_NumberOfBusinessesAcquired" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationConsiderationTransferred1" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_RehabilitationHospitalMember" xlink:type="locator" xlink:label="mpw_RehabilitationHospitalMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MajorPropertyClassDomain" xlink:type="locator" xlink:label="us-gaap_MajorPropertyClassDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MajorPropertyClassAxis" xlink:type="locator" xlink:label="us-gaap_MajorPropertyClassAxis" />
    <link:loc xlink:href="https://xbrl.sec.gov/country/2017/country-2017-01-31.xsd#country_DE" xlink:type="locator" xlink:label="country_DE" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_SegmentGeographicalDomain" xlink:type="locator" xlink:label="srt_SegmentGeographicalDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_StatementGeographicalAxis" xlink:type="locator" xlink:label="srt_StatementGeographicalAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MedianMember" xlink:type="locator" xlink:label="srt_MedianMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_RangeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MedianMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_StatementGeographicalAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_StatementGeographicalAxis" xlink:to="srt_SegmentGeographicalDomain" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="country_DE" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_MajorPropertyClassAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_MajorPropertyClassAxis" xlink:to="us-gaap_MajorPropertyClassDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_MajorPropertyClassDomain" xlink:to="mpw_RehabilitationHospitalMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationConsiderationTransferred1" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_NumberOfBusinessesAcquired" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_LessorOperatingLeaseTermOfContract" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesSummaryOfStatusOnCurrentDevelopmentProjectsDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesSummaryOfStatusOnCurrentDevelopmentProjectsDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesSummaryOfStatusOnCurrentDevelopmentProjectsDetail">
    <link:loc xlink:href="mpw-20200331.xsd#mpw_DevelopmentProjectsEstimatedRentCommencementDate" xlink:type="locator" xlink:label="mpw_DevelopmentProjectsEstimatedRentCommencementDate" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CostOfGoodsAndServicesSold" xlink:type="locator" xlink:label="us-gaap_CostOfGoodsAndServicesSold" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_DevelopmentProjectsOriginalCommitmentAmount" xlink:type="locator" xlink:label="mpw_DevelopmentProjectsOriginalCommitmentAmount" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_HoustonTexasMember" xlink:type="locator" xlink:label="mpw_HoustonTexasMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_BirminghamUkMember" xlink:type="locator" xlink:label="mpw_BirminghamUkMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_SegmentGeographicalDomain" xlink:type="locator" xlink:label="srt_SegmentGeographicalDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_StatementGeographicalAxis" xlink:type="locator" xlink:label="srt_StatementGeographicalAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NeuroPsychiatricHospitalsMember" xlink:type="locator" xlink:label="mpw_NeuroPsychiatricHospitalsMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_CircleRehabilitationMember" xlink:type="locator" xlink:label="mpw_CircleRehabilitationMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_CircleHealthMember" xlink:type="locator" xlink:label="mpw_CircleHealthMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:type="locator" xlink:label="srt_NameOfMajorCustomerDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:type="locator" xlink:label="srt_MajorCustomersAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_MajorCustomersAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_MajorCustomersAxis" xlink:to="srt_NameOfMajorCustomerDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_CircleHealthMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_CircleRehabilitationMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_NeuroPsychiatricHospitalsMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_StatementGeographicalAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_StatementGeographicalAxis" xlink:to="srt_SegmentGeographicalDomain" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="mpw_BirminghamUkMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="mpw_HoustonTexasMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_DevelopmentProjectsOriginalCommitmentAmount" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_CostOfGoodsAndServicesSold" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_DevelopmentProjectsEstimatedRentCommencementDate" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesLeasingOperationsLessorAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesLeasingOperationsLessorAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesLeasingOperationsLessorAdditionalInformationDetail">
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfFinancingLeases" xlink:type="locator" xlink:label="mpw_NumberOfFinancingLeases" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfDirectFinancingLeases" xlink:type="locator" xlink:label="mpw_NumberOfDirectFinancingLeases" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ResidualValueOfLeasedAsset" xlink:type="locator" xlink:label="us-gaap_ResidualValueOfLeasedAsset" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfLessorProperties" xlink:type="locator" xlink:label="mpw_NumberOfLessorProperties" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LeaseFixedMinimumAnnualEscalationsPercentage" xlink:type="locator" xlink:label="mpw_LeaseFixedMinimumAnnualEscalationsPercentage" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LeasesAnnualRentEscalationsPercentage" xlink:type="locator" xlink:label="mpw_LeasesAnnualRentEscalationsPercentage" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorOperatingLeaseRenewalTerm" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseRenewalTerm" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorOperatingLeaseTermOfContract" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseTermOfContract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorLeaseDescriptionLineItems" xlink:type="locator" xlink:label="us-gaap_LessorLeaseDescriptionLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ProspectMedicalHoldingsIncMember" xlink:type="locator" xlink:label="mpw_ProspectMedicalHoldingsIncMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PrimeFacilitiesMember" xlink:type="locator" xlink:label="mpw_PrimeFacilitiesMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ErnestHealthIncMember" xlink:type="locator" xlink:label="mpw_ErnestHealthIncMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:type="locator" xlink:label="srt_NameOfMajorCustomerDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:type="locator" xlink:label="srt_MajorCustomersAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorLeaseDescriptionTable" xlink:type="locator" xlink:label="us-gaap_LessorLeaseDescriptionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LessorOperatingLeaseDescriptionAbstract" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseDescriptionAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorOperatingLeaseDescriptionAbstract" xlink:to="us-gaap_LessorLeaseDescriptionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionTable" xlink:to="srt_RangeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionTable" xlink:to="srt_MajorCustomersAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_MajorCustomersAxis" xlink:to="srt_NameOfMajorCustomerDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_ErnestHealthIncMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_PrimeFacilitiesMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_ProspectMedicalHoldingsIncMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionTable" xlink:to="us-gaap_LessorLeaseDescriptionLineItems" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionLineItems" xlink:to="us-gaap_LessorOperatingLeaseTermOfContract" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionLineItems" xlink:to="us-gaap_LessorOperatingLeaseRenewalTerm" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionLineItems" xlink:to="mpw_LeasesAnnualRentEscalationsPercentage" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionLineItems" xlink:to="mpw_LeaseFixedMinimumAnnualEscalationsPercentage" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionLineItems" xlink:to="mpw_NumberOfLessorProperties" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionLineItems" xlink:to="us-gaap_ResidualValueOfLeasedAsset" order="10430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionLineItems" xlink:to="mpw_NumberOfDirectFinancingLeases" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LessorLeaseDescriptionLineItems" xlink:to="mpw_NumberOfFinancingLeases" order="10540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesComponentsOfTotalInvestmentInFinancingLeasesDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesComponentsOfTotalInvestmentInFinancingLeasesDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesComponentsOfTotalInvestmentInFinancingLeasesDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetInvestmentInLease" xlink:type="locator" xlink:label="us-gaap_NetInvestmentInLease" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_OtherFinancingLeasesNetOfAllowanceForCreditLoss" xlink:type="locator" xlink:label="mpw_OtherFinancingLeasesNetOfAllowanceForCreditLoss" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DirectFinancingLeaseNetInvestmentInLease" xlink:type="locator" xlink:label="us-gaap_DirectFinancingLeaseNetInvestmentInLease" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_DirectFinancingLeaseUnearnedIncomeAndAllowanceForCreditLoss" xlink:type="locator" xlink:label="mpw_DirectFinancingLeaseUnearnedIncomeAndAllowanceForCreditLoss" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DirectFinancingLeaseUnguaranteedResidualAsset" xlink:type="locator" xlink:label="us-gaap_DirectFinancingLeaseUnguaranteedResidualAsset" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DirectFinancingLeaseLeaseReceivable" xlink:type="locator" xlink:label="us-gaap_DirectFinancingLeaseLeaseReceivable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DirectFinancingLeaseNetInvestmentInLeasesAbstract" xlink:type="locator" xlink:label="us-gaap_DirectFinancingLeaseNetInvestmentInLeasesAbstract" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_DirectFinancingLeaseNetInvestmentInLeasesAbstract" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DirectFinancingLeaseNetInvestmentInLeasesAbstract" xlink:to="us-gaap_DirectFinancingLeaseLeaseReceivable" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DirectFinancingLeaseNetInvestmentInLeasesAbstract" xlink:to="us-gaap_DirectFinancingLeaseUnguaranteedResidualAsset" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="mpw_DirectFinancingLeaseUnearnedIncomeAndAllowanceForCreditLoss" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DirectFinancingLeaseNetInvestmentInLeasesAbstract" xlink:to="us-gaap_DirectFinancingLeaseNetInvestmentInLease" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="mpw_OtherFinancingLeasesNetOfAllowanceForCreditLoss" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_NetInvestmentInLease" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesAdeptusHealthAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesAdeptusHealthAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesAdeptusHealthAdditionalInformationDetail">
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PercentageOfInvestmentInRemainingTransitionFacilitiesOnAssets" xlink:type="locator" xlink:label="mpw_PercentageOfInvestmentInRemainingTransitionFacilitiesOnAssets" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ImpairmentOfRealEstate" xlink:type="locator" xlink:label="us-gaap_ImpairmentOfRealEstate" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromLeasePayments" xlink:type="locator" xlink:label="us-gaap_ProceedsFromLeasePayments" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfFacilitiesRentIncreasedDueToDeclineInOperatingResults" xlink:type="locator" xlink:label="mpw_NumberOfFacilitiesRentIncreasedDueToDeclineInOperatingResults" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfFacilitiesSeverDeclineInOperatingResults" xlink:type="locator" xlink:label="mpw_NumberOfFacilitiesSeverDeclineInOperatingResults" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfLeasedProperties" xlink:type="locator" xlink:label="mpw_NumberOfLeasedProperties" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ValueOfRemainingTransitionedFacilities" xlink:type="locator" xlink:label="mpw_ValueOfRemainingTransitionedFacilities" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfTransitionedFacilitiesRemaining" xlink:type="locator" xlink:label="mpw_NumberOfTransitionedFacilitiesRemaining" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfTransitionedFacilitiesReLeasedOrSoldToOtherTenants" xlink:type="locator" xlink:label="mpw_NumberOfTransitionedFacilitiesReLeasedOrSoldToOtherTenants" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfFacilitiesTransitioned" xlink:type="locator" xlink:label="mpw_NumberOfFacilitiesTransitioned" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LetterOfCreditMember" xlink:type="locator" xlink:label="us-gaap_LetterOfCreditMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CreditFacilityDomain" xlink:type="locator" xlink:label="us-gaap_CreditFacilityDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CreditFacilityAxis" xlink:type="locator" xlink:label="us-gaap_CreditFacilityAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_AdeptusHealthMember" xlink:type="locator" xlink:label="mpw_AdeptusHealthMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:type="locator" xlink:label="srt_NameOfMajorCustomerDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:type="locator" xlink:label="srt_MajorCustomersAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_MajorCustomersAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_MajorCustomersAxis" xlink:to="srt_NameOfMajorCustomerDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_AdeptusHealthMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_CreditFacilityAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_LetterOfCreditMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_RangeAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfFacilitiesTransitioned" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfTransitionedFacilitiesReLeasedOrSoldToOtherTenants" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfTransitionedFacilitiesRemaining" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_ValueOfRemainingTransitionedFacilities" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfLeasedProperties" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfFacilitiesSeverDeclineInOperatingResults" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfFacilitiesRentIncreasedDueToDeclineInOperatingResults" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_ProceedsFromLeasePayments" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_ImpairmentOfRealEstate" order="10520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_PercentageOfInvestmentInRemainingTransitionFacilitiesOnAssets" order="10540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesAlectoFacilitiesAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesAlectoFacilitiesAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesAlectoFacilitiesAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ImpairmentOfRealEstate" xlink:type="locator" xlink:label="us-gaap_ImpairmentOfRealEstate" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfFacilitiesDonated" xlink:type="locator" xlink:label="mpw_NumberOfFacilitiesDonated" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskPercentage1" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfLeasedProperties" xlink:type="locator" xlink:label="mpw_NumberOfLeasedProperties" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CustomerConcentrationRiskMember" xlink:type="locator" xlink:label="us-gaap_CustomerConcentrationRiskMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskTypeDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskByTypeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AssetsTotalMember" xlink:type="locator" xlink:label="us-gaap_AssetsTotalMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_AlectoHealthcareServicesMember" xlink:type="locator" xlink:label="mpw_AlectoHealthcareServicesMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:type="locator" xlink:label="srt_NameOfMajorCustomerDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:type="locator" xlink:label="srt_MajorCustomersAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_MajorCustomersAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_MajorCustomersAxis" xlink:to="srt_NameOfMajorCustomerDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_AlectoHealthcareServicesMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_AssetsTotalMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_ConcentrationRiskByTypeAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_CustomerConcentrationRiskMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_RangeAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfLeasedProperties" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_ConcentrationRiskPercentage1" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfFacilitiesDonated" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_ImpairmentOfRealEstate" order="10430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesSummaryOfLoansNetOfAllowanceForCreditLossDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesSummaryOfLoansNetOfAllowanceForCreditLossDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesSummaryOfLoansNetOfAllowanceForCreditLossDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NotesReceivableNet" xlink:type="locator" xlink:label="us-gaap_NotesReceivableNet" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_OtherLoans" xlink:type="locator" xlink:label="mpw_OtherLoans" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_AcquisitionLoans" xlink:type="locator" xlink:label="mpw_AcquisitionLoans" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NotesReceivableGross" xlink:type="locator" xlink:label="us-gaap_NotesReceivableGross" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_NotesReceivableGross" order="10040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="mpw_AcquisitionLoans" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="mpw_OtherLoans" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_NotesReceivableNet" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesLoansAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesLoansAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesLoansAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DueFromJointVentures" xlink:type="locator" xlink:label="us-gaap_DueFromJointVentures" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LoansLineItems" xlink:type="locator" xlink:label="mpw_LoansLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PrimotopHoldingsSARLMember" xlink:type="locator" xlink:label="mpw_PrimotopHoldingsSARLMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:type="locator" xlink:label="srt_NameOfMajorCustomerDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:type="locator" xlink:label="srt_MajorCustomersAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LoansTable" xlink:type="locator" xlink:label="mpw_LoansTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="mpw_LoansTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_LoansTable" xlink:to="srt_MajorCustomersAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_MajorCustomersAxis" xlink:to="srt_NameOfMajorCustomerDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_PrimotopHoldingsSARLMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_LoansTable" xlink:to="mpw_LoansLineItems" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_LoansLineItems" xlink:to="us-gaap_DueFromJointVentures" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesConcentrationOfCreditRisksAndRelatedPartyTransactionsAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureRealEstateAndLendingActivitiesConcentrationOfCreditRisksAndRelatedPartyTransactionsAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureRealEstateAndLendingActivitiesConcentrationOfCreditRisksAndRelatedPartyTransactionsAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskPercentage1" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MaximumPercentageOfEntitysAssetsInvestedOnSingleProperty" xlink:type="locator" xlink:label="mpw_MaximumPercentageOfEntitysAssetsInvestedOnSingleProperty" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfInvestments" xlink:type="locator" xlink:label="mpw_NumberOfInvestments" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LongTermAcuteCareHospitalMember" xlink:type="locator" xlink:label="mpw_LongTermAcuteCareHospitalMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_RehabilitationHospitalMember" xlink:type="locator" xlink:label="mpw_RehabilitationHospitalMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_GeneralAcuteCareHospitalAndHealthcareSystemMember" xlink:type="locator" xlink:label="mpw_GeneralAcuteCareHospitalAndHealthcareSystemMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MajorPropertyClassDomain" xlink:type="locator" xlink:label="us-gaap_MajorPropertyClassDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MajorPropertyClassAxis" xlink:type="locator" xlink:label="us-gaap_MajorPropertyClassAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_GeographicConcentrationRiskMember" xlink:type="locator" xlink:label="us-gaap_GeographicConcentrationRiskMember" />
    <link:loc xlink:href="https://xbrl.sec.gov/country/2017/country-2017-01-31.xsd#country_AU" xlink:type="locator" xlink:label="country_AU" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_EuropeMember" xlink:type="locator" xlink:label="srt_EuropeMember" />
    <link:loc xlink:href="https://xbrl.sec.gov/country/2017/country-2017-01-31.xsd#country_US" xlink:type="locator" xlink:label="country_US" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_SegmentGeographicalDomain" xlink:type="locator" xlink:label="srt_SegmentGeographicalDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_StatementGeographicalAxis" xlink:type="locator" xlink:label="srt_StatementGeographicalAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CreditConcentrationRiskMember" xlink:type="locator" xlink:label="us-gaap_CreditConcentrationRiskMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_LeaseConcentrationMember" xlink:type="locator" xlink:label="mpw_LeaseConcentrationMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ProspectAndCircleMember" xlink:type="locator" xlink:label="mpw_ProspectAndCircleMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_CircleHealthMember" xlink:type="locator" xlink:label="mpw_CircleHealthMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PrimeHealthCareServicesMember" xlink:type="locator" xlink:label="mpw_PrimeHealthCareServicesMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ProspectMedicalHoldingsIncMember" xlink:type="locator" xlink:label="mpw_ProspectMedicalHoldingsIncMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_StewardMember" xlink:type="locator" xlink:label="mpw_StewardMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_NameOfMajorCustomerDomain" xlink:type="locator" xlink:label="srt_NameOfMajorCustomerDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MajorCustomersAxis" xlink:type="locator" xlink:label="srt_MajorCustomersAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SalesRevenueNetMember" xlink:type="locator" xlink:label="us-gaap_SalesRevenueNetMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CustomerConcentrationRiskMember" xlink:type="locator" xlink:label="us-gaap_CustomerConcentrationRiskMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskTypeDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskByTypeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AssetsTotalMember" xlink:type="locator" xlink:label="us-gaap_AssetsTotalMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ProFormaMember" xlink:type="locator" xlink:label="srt_ProFormaMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ScenarioUnspecifiedDomain" xlink:type="locator" xlink:label="srt_ScenarioUnspecifiedDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_StatementScenarioAxis" xlink:type="locator" xlink:label="srt_StatementScenarioAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_StatementScenarioAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_StatementScenarioAxis" xlink:to="srt_ScenarioUnspecifiedDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ScenarioUnspecifiedDomain" xlink:to="srt_ProFormaMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_AssetsTotalMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_ConcentrationRiskByTypeAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_CustomerConcentrationRiskMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_SalesRevenueNetMember" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_MajorCustomersAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_MajorCustomersAxis" xlink:to="srt_NameOfMajorCustomerDomain" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_StewardMember" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_ProspectMedicalHoldingsIncMember" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_PrimeHealthCareServicesMember" order="10520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_CircleHealthMember" order="10540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_ProspectAndCircleMember" order="10560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_NameOfMajorCustomerDomain" xlink:to="mpw_LeaseConcentrationMember" order="10580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_CreditConcentrationRiskMember" order="10640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_RangeAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_StatementGeographicalAxis" order="10030.10" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_StatementGeographicalAxis" xlink:to="srt_SegmentGeographicalDomain" order="10980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="country_US" order="11000.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="srt_EuropeMember" order="11020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="country_AU" order="11040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_GeographicConcentrationRiskMember" order="11100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_MajorPropertyClassAxis" order="10030.12" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_MajorPropertyClassAxis" xlink:to="us-gaap_MajorPropertyClassDomain" order="11300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_MajorPropertyClassDomain" xlink:to="mpw_GeneralAcuteCareHospitalAndHealthcareSystemMember" order="11320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_MajorPropertyClassDomain" xlink:to="mpw_RehabilitationHospitalMember" order="11340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_MajorPropertyClassDomain" xlink:to="mpw_LongTermAcuteCareHospitalMember" order="11360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="11380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_NumberOfInvestments" order="11390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="mpw_MaximumPercentageOfEntitysAssetsInvestedOnSingleProperty" order="11430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_ConcentrationRiskPercentage1" order="11500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtSummaryOfDebtDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureDebtSummaryOfDebtDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtSummaryOfDebtDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebt" xlink:type="locator" xlink:label="us-gaap_LongTermDebt" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DeferredFinanceCostsNet" xlink:type="locator" xlink:label="us-gaap_DeferredFinanceCostsNet" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentCarryingAmount" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentCarryingAmount" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentLineItems" />
    <link:loc xlink:href="https://xbrl.sec.gov/country/2017/country-2017-01-31.xsd#country_AU" xlink:type="locator" xlink:label="country_AU" />
    <link:loc xlink:href="https://xbrl.sec.gov/country/2017/country-2017-01-31.xsd#country_GB" xlink:type="locator" xlink:label="country_GB" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_SegmentGeographicalDomain" xlink:type="locator" xlink:label="srt_SegmentGeographicalDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_StatementGeographicalAxis" xlink:type="locator" xlink:label="srt_StatementGeographicalAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_RevolvingCreditFacilityMember" xlink:type="locator" xlink:label="us-gaap_RevolvingCreditFacilityMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CreditFacilityDomain" xlink:type="locator" xlink:label="us-gaap_CreditFacilityDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CreditFacilityAxis" xlink:type="locator" xlink:label="us-gaap_CreditFacilityAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FourPointSixTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyNineMember" xlink:type="locator" xlink:label="mpw_FourPointSixTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyNineMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ThreePointSixNineTwoPercentageSeniorUnsecuredNotesDueTwoThousandTwentyEightMember" xlink:type="locator" xlink:label="mpw_ThreePointSixNineTwoPercentageSeniorUnsecuredNotesDueTwoThousandTwentyEightMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FivePointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:type="locator" xlink:label="mpw_FivePointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FivePointTwoFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySixMember" xlink:type="locator" xlink:label="mpw_FivePointTwoFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySixMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ThreePointThreeTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFiveMember" xlink:type="locator" xlink:label="mpw_ThreePointThreeTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFiveMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_SixPointThreeSevenFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" xlink:type="locator" xlink:label="mpw_SixPointThreeSevenFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FivePointFiveZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" xlink:type="locator" xlink:label="mpw_FivePointFiveZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_TwoPointFiveFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:type="locator" xlink:label="mpw_TwoPointFiveFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FourPointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyTwoMember" xlink:type="locator" xlink:label="mpw_FourPointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyTwoMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_TermLoanMember" xlink:type="locator" xlink:label="mpw_TermLoanMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentNameDomain" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentAxis" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentTable" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtInstrumentTable" order="10040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_DebtInstrumentAxis" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentAxis" xlink:to="us-gaap_DebtInstrumentNameDomain" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_TermLoanMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FourPointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyTwoMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_TwoPointFiveFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FivePointFiveZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_SixPointThreeSevenFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_ThreePointThreeTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFiveMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FivePointTwoFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySixMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FivePointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_ThreePointSixNineTwoPercentageSeniorUnsecuredNotesDueTwoThousandTwentyEightMember" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FourPointSixTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyNineMember" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_CreditFacilityAxis" order="10050.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_RevolvingCreditFacilityMember" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="srt_StatementGeographicalAxis" order="10050.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_StatementGeographicalAxis" xlink:to="srt_SegmentGeographicalDomain" order="10420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="country_GB" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="country_AU" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_DebtInstrumentLineItems" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentCarryingAmount" order="10490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DeferredFinanceCostsNet" order="11050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LongTermDebt" order="11090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtSummaryOfDebtParentheticalDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureDebtSummaryOfDebtParentheticalDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtSummaryOfDebtParentheticalDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentInterestRateStatedPercentage" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FourPointSixTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyNineMember" xlink:type="locator" xlink:label="mpw_FourPointSixTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyNineMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ThreePointSixNineTwoPercentageSeniorUnsecuredNotesDueTwoThousandTwentyEightMember" xlink:type="locator" xlink:label="mpw_ThreePointSixNineTwoPercentageSeniorUnsecuredNotesDueTwoThousandTwentyEightMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FivePointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" xlink:type="locator" xlink:label="mpw_FivePointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FivePointTwoFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySixMember" xlink:type="locator" xlink:label="mpw_FivePointTwoFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySixMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_ThreePointThreeTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFiveMember" xlink:type="locator" xlink:label="mpw_ThreePointThreeTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFiveMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_SixPointThreeSevenFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" xlink:type="locator" xlink:label="mpw_SixPointThreeSevenFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FivePointFiveZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" xlink:type="locator" xlink:label="mpw_FivePointFiveZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_TwoPointFiveFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" xlink:type="locator" xlink:label="mpw_TwoPointFiveFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FourPointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyTwoMember" xlink:type="locator" xlink:label="mpw_FourPointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyTwoMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentNameDomain" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentAxis" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentTable" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtInstrumentTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_DebtInstrumentAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentAxis" xlink:to="us-gaap_DebtInstrumentNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FourPointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyTwoMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_TwoPointFiveFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyThreeMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FivePointFiveZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_SixPointThreeSevenFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFourMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_ThreePointThreeTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyFiveMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FivePointTwoFiveZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySixMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FivePointZeroZeroZeroPercentageSeniorUnsecuredNotesDueTwoThousandTwentySevenMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_ThreePointSixNineTwoPercentageSeniorUnsecuredNotesDueTwoThousandTwentyEightMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_FourPointSixTwoFivePercentageSeniorUnsecuredNotesDueTwoThousandTwentyNineMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_DebtInstrumentLineItems" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtPrincipalPaymentsDueForDebtDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureDebtPrincipalPaymentsDueForDebtDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtPrincipalPaymentsDueForDebtDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentCarryingAmount" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentCarryingAmount" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalAfterYearFive" xlink:type="locator" xlink:label="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalAfterYearFive" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearFive" xlink:type="locator" xlink:label="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearFive" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearFour" xlink:type="locator" xlink:label="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearFour" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearThree" xlink:type="locator" xlink:label="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearThree" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearTwo" xlink:type="locator" xlink:label="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearTwo" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalRemainderOfFiscalYear" xlink:type="locator" xlink:label="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalRemainderOfFiscalYear" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalRemainderOfFiscalYear" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearTwo" order="10090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearThree" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearFour" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalInYearFive" order="10150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LongTermDebtMaturitiesRepaymentsOfPrincipalAfterYearFive" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtInstrumentCarryingAmount" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtBritishPoundSterlingTermLoanAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureDebtBritishPoundSterlingTermLoanAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtBritishPoundSterlingTermLoanAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentInterestRateStatedPercentage" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_DebtInstrumentVariableInterestRate" xlink:type="locator" xlink:label="mpw_DebtInstrumentVariableInterestRate" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentInterestRateEffectivePercentage" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentInterestRateEffectivePercentage" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_DebtInstrumentEffectiveDate" xlink:type="locator" xlink:label="mpw_DebtInstrumentEffectiveDate" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_DebtInstrumentInterestRateAdjustableBasedOnPricingGridPercentage" xlink:type="locator" xlink:label="mpw_DebtInstrumentInterestRateAdjustableBasedOnPricingGridPercentage" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentMaturityDate" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentMaturityDate" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentLineItems" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentLineItems" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <link:loc xlink:href="https://xbrl.sec.gov/stpr/2018/stpr-2018-01-31.xsd#stpr_CA-BC" xlink:type="locator" xlink:label="stpr_CA-BC" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_SegmentGeographicalDomain" xlink:type="locator" xlink:label="srt_SegmentGeographicalDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_StatementGeographicalAxis" xlink:type="locator" xlink:label="srt_StatementGeographicalAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_CreditRatingMember" xlink:type="locator" xlink:label="mpw_CreditRatingMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_VariableRateDomain" xlink:type="locator" xlink:label="us-gaap_VariableRateDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_VariableRateAxis" xlink:type="locator" xlink:label="us-gaap_VariableRateAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_BankOfAmericaNAMember" xlink:type="locator" xlink:label="mpw_BankOfAmericaNAMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_RepurchaseAgreementCounterpartyNameDomain" xlink:type="locator" xlink:label="srt_RepurchaseAgreementCounterpartyNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_CounterpartyNameAxis" xlink:type="locator" xlink:label="srt_CounterpartyNameAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_TermLoanMember" xlink:type="locator" xlink:label="mpw_TermLoanMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentNameDomain" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentAxis" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtInstrumentTable" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtInstrumentTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_DebtInstrumentAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentAxis" xlink:to="us-gaap_DebtInstrumentNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentNameDomain" xlink:to="mpw_TermLoanMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="srt_CounterpartyNameAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_CounterpartyNameAxis" xlink:to="srt_RepurchaseAgreementCounterpartyNameDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="mpw_BankOfAmericaNAMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_VariableRateAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateDomain" xlink:to="mpw_CreditRatingMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="srt_StatementGeographicalAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_StatementGeographicalAxis" xlink:to="srt_SegmentGeographicalDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_SegmentGeographicalDomain" xlink:to="stpr_CA-BC" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="srt_RangeAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentTable" xlink:to="us-gaap_DebtInstrumentLineItems" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentMaturityDate" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="mpw_DebtInstrumentInterestRateAdjustableBasedOnPricingGridPercentage" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="mpw_DebtInstrumentEffectiveDate" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentInterestRateEffectivePercentage" order="10570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="mpw_DebtInstrumentVariableInterestRate" order="10610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtInstrumentLineItems" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage" order="10650.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtCovenantsAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureDebtCovenantsAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureDebtCovenantsAdditionalInformationDetail">
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MaximumPercentageOfUnencumberedAssets" xlink:type="locator" xlink:label="mpw_MaximumPercentageOfUnencumberedAssets" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PercentageOfDividendsPayableOnSeniorUnsecuredNotes" xlink:type="locator" xlink:label="mpw_PercentageOfDividendsPayableOnSeniorUnsecuredNotes" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_PercentageOfDividendsPayableOnBasisOfAdjustedOperatingFunds" xlink:type="locator" xlink:label="mpw_PercentageOfDividendsPayableOnBasisOfAdjustedOperatingFunds" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="mpw_PercentageOfDividendsPayableOnBasisOfAdjustedOperatingFunds" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="mpw_PercentageOfDividendsPayableOnSeniorUnsecuredNotes" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="mpw_MaximumPercentageOfUnencumberedAssets" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureCommonStockPartnersCapitalAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureCommonStockPartnersCapitalAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureCommonStockPartnersCapitalAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_PartnersCapitalAccountUnitsSaleOfUnits" xlink:type="locator" xlink:label="us-gaap_PartnersCapitalAccountUnitsSaleOfUnits" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NumberOfPartnersSharedRemainingOwnershipInterest" xlink:type="locator" xlink:label="mpw_NumberOfPartnersSharedRemainingOwnershipInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LimitedLiabilityCompanyLLCOrLimitedPartnershipLPMembersOrLimitedPartnersOwnershipInterest" xlink:type="locator" xlink:label="us-gaap_LimitedLiabilityCompanyLLCOrLimitedPartnershipLPMembersOrLimitedPartnersOwnershipInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProceedsFromIssuanceOfCommonStock" xlink:type="locator" xlink:label="us-gaap_ProceedsFromIssuanceOfCommonStock" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesNewIssues" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesNewIssues" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ClassOfStockLineItems" xlink:type="locator" xlink:label="us-gaap_ClassOfStockLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_EmployeeMember" xlink:type="locator" xlink:label="mpw_EmployeeMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_TitleOfIndividualWithRelationshipToEntityDomain" xlink:type="locator" xlink:label="srt_TitleOfIndividualWithRelationshipToEntityDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_TitleOfIndividualAxis" xlink:type="locator" xlink:label="srt_TitleOfIndividualAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_OperatingPartnershipMember" xlink:type="locator" xlink:label="mpw_OperatingPartnershipMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventMember" xlink:type="locator" xlink:label="us-gaap_SubsequentEventMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventTypeDomain" xlink:type="locator" xlink:label="us-gaap_SubsequentEventTypeDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_SubsequentEventTypeAxis" xlink:type="locator" xlink:label="us-gaap_SubsequentEventTypeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_AtTheMarketEquityOfferingProgramMember" xlink:type="locator" xlink:label="mpw_AtTheMarketEquityOfferingProgramMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityInterestIssuedOrIssuableTypeDomain" xlink:type="locator" xlink:label="us-gaap_EquityInterestIssuedOrIssuableTypeDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityInterestIssuedOrIssuableByTypeAxis" xlink:type="locator" xlink:label="us-gaap_EquityInterestIssuedOrIssuableByTypeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfStockByClassTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfStockByClassTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EquityAbstract" xlink:type="locator" xlink:label="us-gaap_EquityAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityAbstract" xlink:to="us-gaap_ScheduleOfStockByClassTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_EquityInterestIssuedOrIssuableByTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityInterestIssuedOrIssuableByTypeAxis" xlink:to="us-gaap_EquityInterestIssuedOrIssuableTypeDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityInterestIssuedOrIssuableTypeDomain" xlink:to="mpw_AtTheMarketEquityOfferingProgramMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_SubsequentEventTypeAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeAxis" xlink:to="us-gaap_SubsequentEventTypeDomain" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeDomain" xlink:to="us-gaap_SubsequentEventMember" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="srt_OwnershipAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="mpw_OperatingPartnershipMember" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="srt_TitleOfIndividualAxis" order="10030.10" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_TitleOfIndividualAxis" xlink:to="srt_TitleOfIndividualWithRelationshipToEntityDomain" order="10520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_TitleOfIndividualWithRelationshipToEntityDomain" xlink:to="mpw_EmployeeMember" order="10540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_ClassOfStockLineItems" order="10620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesNewIssues" order="10630.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ProceedsFromIssuanceOfCommonStock" order="10670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_LimitedLiabilityCompanyLLCOrLimitedPartnershipLPMembersOrLimitedPartnersOwnershipInterest" order="10810.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="mpw_NumberOfPartnersSharedRemainingOwnershipInterest" order="10850.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_PartnersCapitalAccountUnitsSaleOfUnits" order="10920.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureStockAwardsAdditionalInformationDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureStockAwardsAdditionalInformationDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureStockAwardsAdditionalInformationDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensation" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensation" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_EquityIncentivePlanMember" xlink:type="locator" xlink:label="mpw_EquityIncentivePlanMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="mpw_EquityIncentivePlanMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAvailableForGrant" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensation" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsSummaryOfFairValueInformationOfFinancialInstrumentsDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureFairValueOfFinancialInstrumentsSummaryOfFairValueInformationOfFinancialInstrumentsDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsSummaryOfFairValueInformationOfFinancialInstrumentsDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebtFairValue" xlink:type="locator" xlink:label="us-gaap_LongTermDebtFairValue" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LoansHeldForSaleFairValueDisclosure" xlink:type="locator" xlink:label="us-gaap_LoansHeldForSaleFairValueDisclosure" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ReceivablesFairValueDisclosure" xlink:type="locator" xlink:label="us-gaap_ReceivablesFairValueDisclosure" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_LongTermDebt" xlink:type="locator" xlink:label="us-gaap_LongTermDebt" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_Loans" xlink:type="locator" xlink:label="mpw_Loans" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_InterestAndRentReceivable" xlink:type="locator" xlink:label="mpw_InterestAndRentReceivable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="mpw_InterestAndRentReceivable" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="mpw_Loans" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_LongTermDebt" order="10090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_ReceivablesFairValueDisclosure" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_LoansHeldForSaleFairValueDisclosure" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_LongTermDebtFairValue" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsSummaryOfFairValueInformationOfFinancialInstrumentsParentheticalDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureFairValueOfFinancialInstrumentsSummaryOfFairValueInformationOfFinancialInstrumentsParentheticalDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsSummaryOfFairValueInformationOfFinancialInstrumentsParentheticalDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InvestmentOwnedAtCost" xlink:type="locator" xlink:label="us-gaap_InvestmentOwnedAtCost" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InvestmentOwnedAtFairValue" xlink:type="locator" xlink:label="us-gaap_InvestmentOwnedAtFairValue" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisLineItems" xlink:type="locator" xlink:label="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisLineItems" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_MortgagesMember" xlink:type="locator" xlink:label="us-gaap_MortgagesMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InvestmentTypeCategorizationMember" xlink:type="locator" xlink:label="us-gaap_InvestmentTypeCategorizationMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_InvestmentTypeAxis" xlink:type="locator" xlink:label="us-gaap_InvestmentTypeAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementsRecurringMember" xlink:type="locator" xlink:label="us-gaap_FairValueMeasurementsRecurringMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueMeasurementFrequencyDomain" xlink:type="locator" xlink:label="us-gaap_FairValueMeasurementFrequencyDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueByMeasurementFrequencyAxis" xlink:type="locator" xlink:label="us-gaap_FairValueByMeasurementFrequencyAxis" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisTable" xlink:type="locator" xlink:label="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_FairValueDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisTable" xlink:to="us-gaap_FairValueByMeasurementFrequencyAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByMeasurementFrequencyAxis" xlink:to="us-gaap_FairValueMeasurementFrequencyDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueMeasurementFrequencyDomain" xlink:to="us-gaap_FairValueMeasurementsRecurringMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisTable" xlink:to="us-gaap_InvestmentTypeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeAxis" xlink:to="us-gaap_InvestmentTypeCategorizationMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_MortgagesMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisTable" xlink:to="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisLineItems" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisLineItems" xlink:to="us-gaap_InvestmentOwnedAtFairValue" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="mpw_FinancialInstrumentsMeasuredAtFairValueOnRecurringBasisLineItems" xlink:to="us-gaap_InvestmentOwnedAtCost" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </link:presentationLink>
  <link:roleRef roleURI="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureEarningsPerShareUnitCalculationOfEarningsPerShareDetail" xlink:href="mpw-20200331.xsd#Role_DisclosureEarningsPerShareUnitCalculationOfEarningsPerShareDetail" xlink:type="simple" />
  <link:presentationLink xlink:type="extended" xlink:role="http://www.medicalpropertiestrust.com/20200331/taxonomy/role/DisclosureEarningsPerShareUnitCalculationOfEarningsPerShareDetail">
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" xlink:type="locator" xlink:label="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_NetIncomeLessParticipatingSecuritiesShareInEarnings" xlink:type="locator" xlink:label="mpw_NetIncomeLessParticipatingSecuritiesShareInEarnings" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_UndistributedEarningAllocatedToParticipatingSecurities" xlink:type="locator" xlink:label="mpw_UndistributedEarningAllocatedToParticipatingSecurities" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ProfitLoss" xlink:type="locator" xlink:label="us-gaap_ProfitLoss" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareBasicLineItems" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareBasicLineItems" />
    <link:loc xlink:href="mpw-20200331.xsd#mpw_MptOperatingPartnershipLPMember" xlink:type="locator" xlink:label="mpw_MptOperatingPartnershipLPMember" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesDomain" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesDomain" />
    <link:loc xlink:href="http://xbrl.fasb.org/srt/2019/elts/srt-2019-01-31.xsd#srt_ConsolidatedEntitiesAxis" xlink:type="locator" xlink:label="srt_ConsolidatedEntitiesAxis" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_ScheduleOfEarningsPerShareBasicByCommonClassTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfEarningsPerShareBasicByCommonClassTable" />
    <link:loc xlink:href="http://xbrl.fasb.org/us-gaap/2019/elts/us-gaap-2019-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareAbstract" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_ScheduleOfEarningsPerShareBasicByCommonClassTable" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfEarningsPerShareBasicByCommonClassTable" xlink:to="srt_ConsolidatedEntitiesAxis" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesAxis" xlink:to="srt_ConsolidatedEntitiesDomain" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ConsolidatedEntitiesDomain" xlink:to="mpw_MptOperatingPartnershipLPMember" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfEarningsPerShareBasicByCommonClassTable" xlink:to="us-gaap_EarningsPerShareBasicLineItems" order="10150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicLineItems" xlink:to="us-gaap_ProfitLoss" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicLineItems" xlink:to="us-gaap_NetIncomeLossAttributableToNoncontrollingInterest" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedTerseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicLineItems" xlink:to="mpw_UndistributedEarningAllocatedToParticipatingSecurities" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicLineItems" xlink:to="mpw_NetIncomeLessParticipatingSecuritiesShareInEarnings" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicLineItems" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicLineItems" xlink:to="us-gaap_IncrementalCommonSharesAttributableToShareBasedPaymentArrangements" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <link:presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicLineItems" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </link:presentationLink>
</link:linkbase>
