Objectives: Malaria remains a major public health problem and leading cause of morbidity and mortality in tropical countries. A variety of direct and indirect effects on hematological alterations like anemia, leukocytosis or leukopenia, thrombocytopenia and rarely DIC have been reported in malaria. Aim: The present study aimed to evaluate the alteration of hematological parameters in malaria and their probability to detect malaria in acute febrile illness cases. Methods: This was a case-control study. A total of 40 patients’ diagnosed of malaria as cases and 40 acute febrile illness malaria negative patients as control were enrolled and analysed. Diagnosis of malaria was made by microscopy of peripheral blood smear. Clinical presentation and hematological parameters were studied in all the malaria cases and controls. Results: Out of total malaria cases 53%were infected with Plasmodium vivax (PV) and 47% were of Plasmodium falciparum (PF). Majority of the malaria cases (77.5%) were 18-30 years of age,predominantly male. Mean age±SD among cases was 28.46± 3.59 years. Among clinical presentation, most of the participants (75% cases & 65% control) were observed continuous fever. Splenomegaly was found in 60% of malaria cases and only 7.5% of non malaria control this was statistically significant (p<0.05). There was a statistically significant difference in hemoglobin, platelet counts, total leucocyte count and RDW (p<0.05) levels in patients with malaria compared to patients without malaria. Conclusion: Anemia and thrombocytopenia was the most common hematological changes in malaria cases, canbehelpful in detecting early complications, to monitor and treat them effectivelylead to reduced mortality.