Hend looked in trouble when he landed in a greenside bunker on the first playoff hole but it was his turn to celebrate minutes later when he landed a four-footer after his opponent’s birdie putt had stopped just short of the hole.
It was a third European Tour and 10th Asian Tour title for the big-hitting 45-year-old, who spent two years on the PGA Tour from 2004.
Earlier Hend, who started the round three shots behind the Spaniard, had made all the running on another day of stifling heat in the Malaysian capital with six birdies and a single bogey as he hit a 67 for the second day in a row.
His drives, although typically long, were not always accurate and he had to scrap for some of his birdies on the green, not least at the sixth and seventh holes when he drained lengthy putts to join Elvira at the top of the leaderboard.
An accurate drive and an aggressive approach shot to within six feet at the ninth earned the Queenslander another birdie and the sole lead.
He bogeyed the 10th but Elvira did too and when Hend extended his lead to two shots with his final shot at the 13th, it looked like the title was his.
Elvira, who led by two shots coming into the final round, had never really got going but a birdie at the 16th finally put him under par for the day, and a shot behind Hend overall, to set up the late drama.
Thailand’s Jazz Janewattananond threatened to challenge when he bagged three birdies in his first seven holes but failed to kick on and he finished third two shots behind the leaders and a shot in front of fourth-placed American Johannes Veerman.
South Africa’s former world number one Ernie Els finished in a share of seventh on 10-under after a 71.