Malaria, a vector-borne febrile infection, is one of the major causes of disease for people living in tropical and subtropical regions worldwide. During the period 1980-2007, 579 cases were registered in Romania in individuals traveling to and from malaria-endemic countries. The median number of malaria cases per year was 20 with a range of 5 to 53, and in 67.7% (n = 392) of these cases, the causative protozoan species was Plasmodium falciparum. Most of Romania's malaria cases were recorded during the period 1996-2000 resulting from the massive emigration of its citizens seeking better jobs abroad. The international destinations that held the highest risk of acquiring Romania's malaria were the African countries where P. falciparum was largely responsible for infection. Although prophylaxis has been mandatory for such travelers, failure to prevent the disease in these individuals was likely because of underestimation of the infective risk.