Background: Health centre and hospital records are important sources of data on malaria cases,rnadmissions and deaths, because they are readily available and can provide use full indications on thernpatterns of malaria at a low cost. However, there is only limited information on the health impact ofrnexpanded coverage of malaria control and preventative strategies in Ethiopia.rnObjective: The core objectives of this study is to asses and document the trend of malaria cases,rnadmission and deaths over the past 9 years (2000 -2008) period and describe the impact of antirnmalaria interventions performed during the period. It also aims to assess the relationship betweenrnmeteorological factors and malaria.rnMethodology: The study was conducted in Amhara region, north western Ethiopia. The present studyrnutilized a retrospective record review on available medical records related to malaria from healthrnfacilities for nine years between 2000 and 2008 (except for Bahirdar health centre for 10.5 years: July,rn1998-December, 2008) and metrological information for 9 years (July, 1998-December, 2007) fromrnNational Metrology Agency for Ethiopia. With the limited resource available, total of 14 healthrnfacilities (9 health centres and 5 hospitals) was purposively selected. Data was entered and cleanedrnusing SPSS version 11.0 and analysed using excel 2007 and EPI INFO windows version and SPSSrnversion 11.0 statistical software packages. To assess the trend of malaria and the impact of scale uprninterventions, the observed 2008 value for each indicator was compared with its corresponding,rnexpected value for that year based on the linear trend over 2000 through 2005 (using SPSS Inc.,rnversion 11.0 for linear regression, excel 2007and 2-tailed Student's T-tests for assessing statisticalrnsignificance of the difference between observation and expectation). The Chi squared test for trendrnwas used to test whether the malaria cause outpatient cases, admission and death statisticallyrnsignificant decreasing over time (in years). Correlation statistical test was also applied to test for anyrnassociation between malaria specific morbidity variables and meteorological factors.rnResult: Malaria was responsible for 25.8 % of the total outpatient consultations, 13.9% of the totalrninpatient cases and 15.0 % of the total death between 2000 and 2008. Comparing 2008 against thernaverage 2000-2005, observed declines were 30.2% for total malaria cause outpatient cases and 75.8%rnfor microscopically confirmed malaria cause outpatient cases. After adjusting the pre-interventionrntrends over 2000-2005, the estimated decline in total malaria cause (62.2%; P