We studied 50 cases of complicated falciparum malaria in order to evaluate the different clinical presentations. Thirty five had cerebral malaria while 15 presented with extracerebral features including diarrhea and vomiting (n = 6), hepatitis (n = 4), acute renal failure (n = 3), and gastrointestinal bleeding (n = 2). These cases were treated with quinine. Mortality was higher in extracerebral form (33.3%) as compared to cerebral malaria (22%). Our study suggests that even though cerebral malaria remains the single most important cause of high mortality in complicated falciparum malaria, extracerebral presentation of falciparum malaria is equally life threatening and should be viewed seriously.