Malaria, which was eliminated from mainland France and then from the French West Indies and Réunion during the 20th century, remains endemic in two territories of the French Republic: the department of French Guiana and the territorial collectivity of Mayotte. Despite differences in the species involved and epidemiological profiles, efforts undertaken over the past decade in these two territories have led to a marked improvement in the situation in quantitative terms (number of cases and severe cases reported). The situation remains concerning, however, in qualitative terms, with the emergence of resistance to antimalarial drugs and logistical and regulatory challenges in accessing treatment in the field. While malaria disappeared from mainland France and the other overseas departments half a century ago, competent vectors remain present throughout or in parts of these territories and can lead to limited outbreaks.