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Purpose: The usage of LLITNs in malaria vector control has resulted in the reduction in malaria deaths among higher-risk groups (pregnant women and under-fives). However, there exists asymptomatic infection among older children, thereby making them a reservoir of malaria transmission. This study aimed at assessing the impact of LLITN usage on malaria prevalence among school-age children (SAC) in Ekiti, South Western Nigeria.Methods: Cross-sectional, two-stage cluster sampling technique was used to collect data from SAC during May and June 2017. A total of 1313 (Oye LGA: 657 and Ikole LGA: 656) SAC in selected public primary schools participated in the study. Sociodemographic information as well as data on LLITN usage the previous night was obtained using pretested, semistructured questionnaires adapted from the standardized Malaria Indicator Survey (MIS) tools. Malaria infection was diagnosed by using the rapid diagnostic test (RDT) on blood samples that were collected by finger prick from each child. Data were analyzed using the Statistical Package for Social Sciences (SPSS) for Windows software version 26 (SPSS Inc., Chicago, IL, USA).Results: Usage of LLITNs among SAC was significantly higher in Ikole LGA than in Oye (p < 0.001). Socioeconomic factors (access to electricity, mother's occupation, and household size) showed significant associations with LLITN usage (p < 0.001) in both Oye and Ikole LGAs. Malaria prevalence was significantly low among SAC utilizing LLITNs in both Oye and Ikole LGAs (p < 0.001). There was a significant association between gender and malaria prevalence among SAC with males having higher prevalence than females (p < 0.001). Socioeconomic factors were significantly associated with malaria prevalence in both LGAs (p < 0.001).Conclusion: The usage of LLITNs caused a significant reduction in malaria prevalence among the school-age children in the study areas; hence, sensitization on usage should be scaled up towards malaria elimination. [ABSTRACT FROM AUTHOR]