Globally, malaria increase the rate maternal mortality. Nigeria has high malaria endemicity and the world's highest malaria burden. Nigeria reports about 51 million cases and 31.3% mortality annually, while 97% of the population (213.4m) is at risk. Malaria killed no fewer than 200,000 Nigerians, of which there were 61 million cases that were responsible for 11% of maternal mortality in Nigeria in 2021. This study examined the prevalence and patterns of malaria endemicity among pregnant women in Ondo State, and determined the malaria prevalence from 2013–2017. Geospatial technology was employed to examine the distribution of malaria cases among pregnant women and one-way Analysis of Variance (ANOVA) was used to determine the malaria prevalence in eight Local Government Areas. Temporal analysis revealed a gradual increase in malaria occurrence over the years. In 2013, 2015, and 2017, Akure South recorded the highest prevalence, with approximately 8 cases (40.11%), 5 cases (23.64%), and 9 cases (27.94%) per 1000 pregnant women, respectively. Ondo East had the highest prevalence of 9 cases (27.06%) in 2014, while in 2016, Akoko Southwest had the highest prevalence of 3 cases (19.04%) per 1000 pregnant women. The cumulative malaria patterns for the five years showed that Akure South had the highest prevalence of 18.76–31.42 per 1000 pregnant women. In contrast, the lowest prevalence occurred in Odigbo and Okitipupa having 5–9 cases per 1000 pregnant women. From 2013–2017, findings showed variations in the disease's prevalence in Ondo state.