Malaria is a protozoan disease that is transmitted by the Anopheles mosquito. It can however be transmitted by blood transfusion if the blood donor is parasitaemic. Of the five species of Plasmodium that causes malaria, P. falciparum causes the most severe form of malaria. Nearly half of the world’s population is at risk of malaria. Mortality due to malaria has reduced by 48% from 839,000 deaths in 2000 to 438,000 deaths in 2015. This is largely due to a combination of two approaches, vector control and effective antimalarial drugs There are challenges to be encountered in managing malaria risk. Some have evolved from the interventions while others may be inherent with parasite. The complex life cycle of the plasmodium parasite and the different stages it undergoes both in the mosquito and human requires a multifaceted approach to reduce or eliminate the burden of malaria. The challenges faced in transfusion-transmitted malaria mirrors the global malaria risk. The presence of parasitaemia in blood donors represents a risk for the transmission of malaria by transfusion as well as serving as a reservoir for environmental transmission. Yet, there is no ideal method for parasite detection. There is the need for institutions such as National Blood Services and Malaria Control programmes to collaborate and lead joint interventions that reduce the malaria risk. Such collaborations should also involve stake holders such as academia, policy makers, funders, governments and international organizations.