We report on an 8-year-old girl with Plasmodium falciparum malaria complicated by splenic abscess during the course of her infection. The diagnosis of malaria was based upon the demonstration of trophozoites of P. falciparum in the peripheral blood smear. The trophozoites of the same organism were visualized on the Giemsa-stained smear prepared from the percutaneous splenic aspirate specimen. The patient failed to respond to parenteral Artesunate alone, which demanded emergent splenectomy. To our knowledge, this is the first report of splenic abscess complicating the course of childhood P. falciparum malaria in the English literature.