Introduction - The objective of this study is to describe trends in the epidemiology of malaria in Mayotte, based on data collected between January 2005 and December 2006 and in comparison with previous studies. Method - Surveillance was based on reports by physicians of malaria cases meeting a clinical definition and testing positive on the Optimal® test, as well as on the collection of data on hospitalizations and deaths attributable to malaria. Results - During the study period, 996 cases were reported, representing an annual incidence of 3.1 per 1,000. The 15–24 age group among men was the most affected (7.4 per 1,000). The municipality of Bandraboua had the highest incidence rate, at over 31 per 1,000. Of these 996 cases, 185 were imported (19%), primarily from other islands in the Comoros archipelago; 111 cases were hospitalized (11%); and one death from cerebral malaria occurred. Discussion - Malaria remains a public health problem in Mayotte, although there has been an overall decrease in the annual incidence rate in recent years. Epidemiological surveillance and vector control efforts must be further strengthened in the context of necessary collaboration with neighboring countries. (R.A.)