East Sumba is a district in Sumba Island with high endemicity of malaria. The environment condition and geographical location can support the spread of malaria infection. This is a cross-sectional design research. The result shows that the spreading of malaria case is in 0 to 1000 meters from human settlements and spread evenly in remote villages. Breeding habitat are buffalo footprints, puddles, rice fields, rivers, buffalo wallows, gutters and trenches. With pH of water around 7 until 9 and the highest salt concentration is 1 ppm. It's breeding habitat is more in the turbid water and exposed by sunlight directy. Types of water biota which is exist on the breeding habitat are alga, moss, grass, paddy, Aplocheilus panchax, Oreochromis sp. and water hyacinth. As the conclusion, malaria case spreads indigenously and the area is very potential for Anopheles spp. to breed.