Introduction: Malaria is the most common parasitic infection in the world. It is present in the endemic-epidemic state south of the Sahara and is responsible for high morbidity and mortality, following the complications observed in its evolution. This work aims to objectify the contribution of malaria in the genesis of severe anemia in children aged 0 to 59 months. Patients & Methods: This is a retrospective and descriptive cross-sectional study of pre-school children hospitalized at the Moba Reference General Hospital for severe anemia from 2013 to 2014, ie two years. Results: Of 2410 hospitalizations, 1044 children aged zero to 59 months (43.3%) were anemic. An average age of 24.2 months and a significant predominance in children under three years of age; the female sex slightly affected in a non-significant way; the etiological analysis showed significantly that malaria (80.5%) is the leading cause of severe anemia, followed by malnutrition (7.3%) and intoxication with indigenous products (5.8%). ). Tachycardia (97.3%), cutaneo-mucous pallor (97.1%), tachypnea (87.5%) and fever (84.0%) were more evoked among the clinical signs. In the majority of cases (95.0%), the evolution was good after transfusion (96.5%). Overall mortality was around 5.0%, mainly before transfusion. Conclusion: In endemic areas, malaria must be sought after in children with severe anemia. Preventive measures against malaria need to be strengthened. The use of blood transfusions must take into account the standards in force.