The aim of this retrospective study is to describe the clinical spectrum of severe malaria cases admitted to an ICU and identify factors associated with in-ICU mortality. Parasitological diagnosis was done by thin smear and light microscopic observation; parasitaemia quantification was done whenever possible. Daily smears were done until the Plasmodium smear became negative. Since 2000, a immunochromatographic assay for the qualitative detection of Plasmodium antigens were also used at the emergency department (Malaria Now-Binax ® ). Clinical and laboratory parameters were analysed in order to determine which of them were associated with ICU mortality. To evaluate severity at the ICU admission, the Simplified Acute Physiology Score II (SAPS II) was applied.