Objective: This study was conducted to determine theadvantage of Immunochromatographic test overmicroscopic peripheral smear in clinically suspectedsevere malaria.Methods: Total 106 consecutive clinically diagnosedsevere malaria cases were enrolled with patients over12 years of age irrespective of sex, race, religion andpregnancy from March to August 2002, at onemedicine unit of Chittagong Medical CollegeHospital. The immunochromatographic rapiddiagnosis test and microscopy were performed in allcases.Results: Sensitivity and specificity ofimmunochromatographic Paracheck Pf test wasfound 91.42% and 90.65% in this study. Positivepredictive value was 90.56% and negative predictivevalue was 91.5%. The sensitivity of microscopy wasonly 69.8%.Conclusion: Reliable quality controlled malariamicroscopy is difficult to provide in many ruralremote areas due to lack of logistics manpower andelectricity facility. Rapid diagnostic test likeParacheck Pf test could be of use in such a situationwhich is reliable, cheap and easy to perform.