Recently there is a changing trend not only in the clinical manifestations but also the pattern of complications in malaria. Up to the last decade of 20th century cerebral malaria was the predominant manifestation of severe malaria, whereas, with the beginning of 21st century, jaundice and renal failure become more common complication [8]. Renal involvement has been reported in P. falciparum, P. malariae, and recently in P. vivax infections. Malarial acute renal failure is diagnosed when plasma or serum creatinine >265 µM (3 mg/dl) or blood urea >20 mM. Renal involvement varies from mild proteinuria to severe azotemia associated with metabolic acidosis. The present study was planned in Department of General Medicine, ICARE Institute of Medical Science and Research and Dr Bidhan Chandra Roy Hospital, Haldia. All the patients were informed consents. The aim and the objective of the present study were conveyed to them. Approval of the institutional ethical committee was taken prior to conduct of this study. Total 50 cases of the malarial infections diagnosed in our hospital were evaluated. The study was planned from September 2013 to July 2014. Renal failure due to malaria is a most common severe manifestation and usually associated with other manifestations of severe malaria. Renal dysfunction is the major cause of death. Although significant number of patients were improved conservatively with antimalarial drugs but the availability of renal replacement therapy for malarial ARF has been shown to improve outcome. Early initiation of anti-malarial therapy and renal replacement therapy, if required, could further reduce mortality and enhance recovery of renal function.