Introduction: Malaria is a public health problem. Severe forms of malaria are linked to high mortality. Objective: To establish the cartography of severe malaria in two health districts in Cuvette-Congo. Methodology: An analytical and cross-sectional study was conducted from January to September 2019 in two health districts of Cuvette-Congo. Children aged three months to 17 years diagnosed with severe malaria were included. The epidemiological, clinical and paraclinical variables were analyzed. The statistical tests used were Pearson's chi 2 and the corrected Yates test. Results: Out of 806 children hospitalized, 277 had severe malaria (34.4%). There were 144 boys and 133 girls, an average of 60.9 months old. Anemia n = 247 (89.2%), repeated seizures n = 66 (23.8%), were the signs of severity observed. The clinical forms were isolated (n = 237) in 85.6% and associated (n = 40) in 14.4%, including 210 (88.6%) anemic form and 27 (11.4%) neurological form. The death occurred in seven cases (2.5%). The predictors of death were coma, jaundice, hypoglycemia, thrombocytopenia, hepatomegaly, undernutrition, dehydration and delayed consultation. Conclusion: The large number of cases of severe malaria in Cuvette, often in children under five years old, requires that the national program for control of malaria be strengthened by insisting on a wide distribution of long-lasting insecticide-treated mosquito nets.

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