A retrospective study of cerebral malaria was performed in the Department of Internal Medicine, Bethesda Hospital - Tomohon, North Sulawesi, from January 1983 until October 1989. Among 2261 cases of malaria admitted in this hospital, there were 72 cases of cerebral malaria. The proportion of cerebral malaria cases increased from 0.8 % in 1983 to 6.4% in 1989. The mortality increased in the last 2 years, in spite of the same protocol-therapy in Bethesda Hospital. The total mortality was 30.5 %. There were 37 men and 35 women with an age distribution of 13-79 years. Parasitemia of more than 2 % occurs in 18 % and less than 2 % in 82 %. Complications were anemia 34%; hypoglycemia 9 %; creatinine 2 mg % in 36 %; hyponatremia 92 % and hyperbilirubenemia in 50 %. Several factors influencing the mortality were : Hypoglycemia less than 50 mg %Decreased conciousness level to sopor and comaCreatinine more than 2 mg %Total bilirubine more than 2 mg %More than one organ involvement for complications.Delayed and insufficient treatment.Probable resistence to treatment (quinine or chloroquine) It is not certain which factors have a dominant role in mortality but in a condition with more than one factor the mortality was very high.