Acute febrile illness (AFI) is an illness characterized by a sudden onset of rnincrease in body temperature to a level above normal. The causes of AFIrnremain undifferentiated in many parts of the world. Their burden isrnchallenging particularly in resource poor countries like Ethiopia. Among thisrnmalaria is a major cause of morbidity and mortality in tropical and subtropicalrnrnregions. A cross sectional study was conducted during Decemberrn2011 at Felegeselam health center in North western Ethiopia to determinernprevalence and risk factors of malaria among 398 acute febrile patients inrnrelation to their blood type. The data were collected through structuralrnquestionnaire and laboratory tests like blood film, blood grouping, widal andrnweil felix. The analysis of generated data revealed that the prevalence ofrnMalaria, typhoid, typhus and relapsing fever were 51.5%, 10.3%, 5% and 0%;rnrespectively. Malaria prevalence found to be the highest among other AFIsrnfollowed by typhoid and typhus. Of the malaria infections Plasmodium rnfalciparum accounts 49.75% (n= 201). The percentage of severe malaria withrnrespect to blood group A, B, AB and O was found to be 40%, 34.1%,rn14.3% and 5.1%; respectively. The association of severe malaria with non ‘O’ rnblood types was statistically significant (Xrn= 31.246, P