BackgroundMalaria infections affect a high percentage of the world's population, especially in tropical and subtropical regions. Specifically, Plasmodium falciparum is the most relevant species involved in the etiopathogenesis of this infection. The duration of P. falciparum infections is often undefined, as some reported episodes of suspected recrudescence occur several years after initial exposure.Case presentationWe present a case report of malaria infection with low parasitaemia in a man whose last stay in an endemic region or contacts with the local population was twelve years ago. The patient recovered fully with adequate antimalarial treatment, but some aspects of his clinical history were not clearly defined.ConclusionsWe discuss here the possibility that this is either a P. falciparum recrudescence or an episode of cryptic malaria, as we cannot carefully verify some details of our patient's life and history.