Abstract:Introduction: There is a paucity of studies on the relationship between ABO blood group and its influence on malarial infection. This study was undertaken to study the relationship of severity of malaria with blood groups and to evaluate if ABO blood groups show differential susceptibility to falciparummalaria. Methods: In 200 malaria positive patients, blood group analysis was done. Patients with at least one of the following complications was considered complicated malaria cases, ie: cerebral malaria, severe anemia, circulatory collapse, jaundice, hematuria, bleeding manifestations, acute respiratory distress syndrome, and death. Results: Vivax malaria (75.5%) and blood group O (43%) were the commonest amongst the cases. No significant relationship was present between blood groups and type of infection, parasite load vs blood groups, and complicated cases vs parasite load. Uncomplicated (62%) cases were more than complicated (31%) cases. Blood group O dominated among complicated (37.9%) and uncomplicated (45.65%) cases. No signifiant correlation was present between blood groups and distribution of complicated cases, and between complicated falciparum cases and blood groups. Seven cases of mixed malaria had blood group A and O. Among A blood group, 57.1% of the mixed malaria cases had complications, whereas in O blood group only 14.3% had complications. There was a statistically significant relation between complicated mixed malaria cases and blood groups, with blood group A being more prone to complications. (X 2 =15.131; P=0.019). Conclusions: Blood group O was the dominant blood type in both complicated and uncomplicated malaria cases. Blood group A cases were more prone to severe mixed malaria infections while, blood group O had a favorable clinical outcome.