In 1979, the World Health Organization (WHO) certified the elimination of malaria in Réunion. However, Réunion remains a malaria-prone area: Anopheles arabiensis, the primary malaria vector on Réunion, is present throughout the island’s coastal areas, and increased travel to and from neighboring malaria-endemic countries contributes to the ongoing importation of Plasmodium by travelers. This therefore results in a real risk of secondary indigenous transmission of malaria in Réunion. The objectives of this study are to describe the current epidemiological situation of malaria in Réunion based on data collected between January 1, 2003, and December 31, 2004; to propose recommendations for improving the epidemiological and entomological surveillance system, as well as control measures.