Management of severe imported malaria in adults

•Severe malaria accounts for approximately 10% of all cases of imported malaria in France, mainly due to Plasmodium falciparum.•On the basis of WHO criteria, the French definition of severe imported malaria in adults has been progressively adjusted to the European healthcare level.•Management of severe imported malaria is an emergency, which must be initially conducted in the intensive care unit.•Anti-infective treatment is now based on intravenous artesunate, which must be available in every hospital.•Critical care management of organ failure is essential, particularly for the most severe presentations.