Malaria is a devastating disease, inflicting epidemic morbidity and mortality with an estimated 500 million cases and 2.5 million deaths annually. Children suffer the most severe morbidity; one child dies of malaria every 30 seconds, accounting for over 1 million of the deaths annually. There continues to be a tremendous increase in human migration and travel between malaria endemic and nonendemic areas, with approximately 20% of imported malaria cases to Europe and the United States occurring in children [R. Newman, Personal communication]. Although many recent advances in the prevention, diagnosis, and treatment of malaria have been made, the emergence of drug resistance and changes in the disease's epidemiology present new challenges. This article discusses the special considerations encountered in the prevention and treatment of malaria in children.