Congenital malaria is the least known manifestation of malaria and a much neglected area of research. Most of the existing information is limited to case reports in children born to non-immune women. Congenital malaria can be acquired by transmission of parasitised maternal erythrocytes across the placenta due to microdamage. Congenital malaria has been documented for many years but it was previously thought to be uncommon especially in indigenous populations. Many gaps in knowledge remain. There is a need of considering congenital malaria as differential diagnosis even in low endemic areas, especially in countries where there is social practice of moving the pregnant woman to her native place for childbirth, which may be endemic for malaria. Physicians should judge each case individually, considering such factors as reliability of follow-up and access to medical care and advice accordingly.