INTRODUCTION & AIM: Malaria is a major health problem in our country. Our aim is to determine the poor prognosis factors of this pathology.MATERIALS AND METHOD: A retrospective descriptive, analytical study was conducted in the intensive care unit of University Hospital Center of Joseph Raseta Befelatanana, during 24 months (June 2015 to May 2017). The severity was defined according to the recommendations for clinical practice (2007). We compared surviving and non-surviving patients.RESULTS: Fifty-six (56) cases were studied. The average age was 30 ± 11 years with a sex ratio of 6. Six cases had pulmonary disease. Neurological failure was present in 29 cases. Forty-seven cases were treated with quinine and 07 cases received norepinephrine. The length of stay was 3.55 ± 2.06 days. Eighteen subjects (32%) died. In multivariate analysis, neurological failure (p = 0.0001), jaundice (p = 0.0016), renal insufficiency (p <0.0001) and use of catecholamine (p = 0.0139) were associated with poor prognosis.CONCLUSION: The mortality of malaria was high. Neurological failure, jaundice, renal insufficiency and use of catecholamine were poor prognostic factors.