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We conducted a retrospective analysis of hematologic changes in 89 patients with imported Plasmodium falciparum malaria. Thirteen (15%) were anemic at presentation, 60 (67%) had thrombocytopenia, and 63% had lymphopenia. There was a significant inverse relationship between parasitemia and platelet count. Anemia is rare among patients with imported malaria, while thrombocytopenia and lymphopenia are common.