Background: As a tropic country Indonesia still faces malaria problems. In Asean, Indonesia is one of three countries with the highest malaria morbidity. In 2007, 396 (80%) of 495 districts/municipalities in Indonesia are malaria. In 2009 the government issued a decree of the minister of health No 293 on malaria elimination. The study aimed to analyze the implementation decree of Ministry of Health No. 293/2009 on malaria elimination. Methods: It was a descriptive study. The study was conducted in 4 provinces, and 4 districts based on malaria elimination stages as in Bali province and Karangasem district, Riau islands province and Bintan district, West Nusa Tenggara province and west Lombok district, and Maluku province and South Halmahera district. The stakeholders were Heads and malaria programmers at province/district Health Offices and the related programs. Data were collected by focus group discussion and secondary data were taken. Data were collected by focus group discussion and secondary data. Analysis for Ministry of Health decree No.293 year 2009 on 1) Comphrehend, 2) Implementation, and, 3) Comittment, 4) Innovation intervension to support malaria elimination, 5) Sustainability of activity community empowerment, 6) Proportion of budget. Results: showed there was district that had not issued local policy on malaria elimination, the implementation with comittment especially that health centers in areas under study corfi rm diagnose by laboratory examination and malaria treatment by Artemisin Combined Therapy (ACT), although there were still treatment to clinical malaria, innovation activities were of bersifat local spesifi c, and reward for Juru Malaria Desa or malaria cadre to increase malaria suspect case detection, and with district budget for malaria program ranged 0,95-5,6% of the total budget. Recomendations: It suggested to advocate all malaria endemic areas to issue local policy on malaria elimination, decide intervension of the priority program with target and time schedule, enhance surveillance especially data analysis for malaria stability, and advocate local government to commit on malaria budgetting, distribution health workers, enhance health infrastructures, and also enhance health system for malaria program activities.