Malaria is not considered endemic in State of Piauí. Methods: Malaria epidemiology was examined using surveillance data. Results: During 2002-2013, of the 484 cases of malaria, 217 were classifi ed as probably acquired in Piauí, most frequently in the Campo Largo, Buriti dos Lopes, and Luzilândia municipalities, and 267 were considered probably imported, from the States of Pará, Maranhão, Amazonas, Roraima, and Rondônia. Probably-imported cases occurred throughout the year, while 80.2% of the probably-acquired cases occurred in April-August, peaking at the end of the rainy season. Conclusions: Malaria surveillance should be intensifi ed. Further ecoepidemiological and entomological studies are needed.