This report presents the epidemiological situation of malaria in Mayotte, with the aim of guiding disease control measures. Malaria surveillance data, hospital records, and death certificates were analyzed for 2003 and 2004. The functioning of the malaria surveillance system was evaluated. In 2003 and 2004, 792 and 743 reported cases of malaria were recorded, respectively. Transmission occurred throughout the year, with an increase during the rainy season. The municipality of Bandraboua, in the north of the island, accounted for nearly 60% of cases. The proportion of imported cases was 14%, primarily from the Comoros. Plasmodium falciparum was the predominant species. The proportion of early treatment failures was less than 2%. Between 1 and 3 deaths attributable to malaria occurred in 2003–2004. Malaria remains a persistent public health problem in Mayotte. The surveillance system allows for effective monitoring of epidemiological trends, but the data it produces are underutilized. Any reduction in surveillance and control measures would risk a resurgence of the epidemic in a population with reduced immunity. (R.A.)