Malaria is essentially a local and focal disease since its transmission depends greatly on local eco-environmental conditions. In India, the incidence of total malaria cases has been contained to around 2–3 million cases per year. However, with the occurrence of outbreaks in different parts of the country since 1994, mortality due to malaria has increased. The challenges posed by changing epidemiological paradigms of malaria, occurrence of outbreaks, increasing trends ofP. falciparum cases, spreading resistance to available anti-malarials and development of resistance of vectors to insecticides are areas for major concern. The National Anti-Malaria Programme has made necessary modifications/adjustments in the malaria control strategy with the adoption of the Global Malaria Control Strategy.