Malaria is the most common tropical parasitic infection imported into NSW. This article presents a review of all cases of malaria diagnosed and notified in NSW and the Australian Capital Territory from 1989 to the end of 2003. Of the four species of malaria infecting humans, , , and , is most likely to be associated with serious illness and death. Therefore, trends in the occurrence of this species over the period are examined. This information is of value to clinicians and public health professionals in highlighting both the importance of rapid and accurate diagnosis of malaria and the changing trends in the origin of imported cases.