The average strength of the garrison was 2,425 men.
In July 1846, the garrison commander Lt Gen Pennefather proposed that in the event of an uprising by the Maltese against their Protestant Masters, the British were to seek refuge in Fort St Elmo.
Pennefather recommended creating a citadel by cutting a ditch between the Grand Harbour and the Quarantine Harbour. Access to the citadel was to be only by a drawbridge. There was to be room for 4,000 English refugees. The plan called for re-supply from the sea, the use of water from the aqueduct, and escape by sea.
Army Medical officers of the Malta garrison were allowed private practice, unlike naval surgeons who were strictly forbidden to do so by their Admiral.