Background: Malaria is a potentially life-threatening disease, which is transmitted by the infectious bite of a female Anopheles mosquito. In Myanmar, malaria is a major public health problem. Various studies have found that hypocholesterolemia correlates with the severity of falciparum malaria. Method: The aim of this study was to study serum total cholesterol in severe falciparum malaria patients. The study was a hospital based, cross sectional, descriptive study on 27 patients with severe falciparum malaria who attended at medical wards of No. (2) Military Hospital (500 Bedded) and No. (1) Defense Services General Hospital (1000 Bedded), Mingalardon. It included male and female patients with severe falciparum malaria with the mean age of 37.29 (SD ± 1.10) years. Results: All patients with severe falciparum malaria had low serum total cholesterol level. Among 27 severe falciparum patients, 21 (77.7 %) patients had serum total cholesterol level between 100 – 120 mg/dl, 5 (18.6%) patients were between 120 – 140 mg/dl, and remaining 1 (3.7 %) patient was < 100 mg/dl. Conclusion: This study illustrates the significant impact of severe falciparum malaria on serum total cholesterol level in adults.