Malaria is endemic in India, causing high morbidity and mortality rate. We report a case of complicated vivax malaria in a 26 year old female patient who came with fever and splenomegaly who was diagnosed after a long and unsuccessful battery of tests for splenomegaly. Routine screening for malaria is essential for all malaria suspected patients with fever in endemic areas. Early diagnosis, treatment and management of malaria could effectively prevent mortality of the individual.