BACKGROUND AND OBJECTIVES: The incidence of malaria is on the raise in South Canara district of Karnataka in the recent years. This study was undertaken to study the hematological changes in malaria and to correlate it with the clinical severity and prognosis.METHODS: Analysis was done on 100 patients over the age group of 15 yr.RESULTS: A total of 100 patients were admitted and treated for malaria. Males (83%) outnumbered females(17%).More common in the age group of 15-35 years. Most of the cases occurred between June to November. P. Vivax (54%) formed the majority of the cases followed by P.Falciparum(25%) and mixed(21%). Thrombocytopenia was the most common cause of severe malaria followed by liver dysfunction, renal failure, anemia. INTERPRETATION AND CONCLUSION: Malaria is a major health problem affecting the younger population. Thrombocytopenia contributed the maximum to the severity with anemia, liver dysfunction, deranged renal parameters concontributing to a lesser extent. Mixed malaria was the leading cause for severe malaria.The prognosis is particularly good with early detection and treatment.