. Almost 80% of the populations in Indonesia live in malaria endemie areas. Until now, AMI was reported to lower high white the MDG target of AMI up to 5 per 10,000 population in 2015. This study aims to formulate the cardinal sign of clinical malaria in Musi Rawas district. Two hundred and eleven samples were taken based on the inclusive case selection criteria include fever> 38°C, chills, sweating and headaches and muscle pain and an enlarged spleen in four health center with AMI> 10,000. There was no significant association between the occurrence of clinical symptoms of malaria, but after the regression analysis obtained the cardinal sign of clinical diagnosis of malaria is fever> 38°C accompanied the headache, chills, cold sweat and nausea and age <39 years with OR 11.3. Clinical diagnosis is confirmed by the cardinal sign of fever > 38°C accompanied the headache, chills, sweating, muscle pain and age <39 years.