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Background: Romania was an endemic malaria country with as many as 300,000 new cases yearly and the eradication was completed in 1962. The permanent risk of malaria re-emergence in Romania maintains because of the simultaneous presence of the Anopheles maculipennis group vector species and imported malaria cases. The risk increased in the present conditions of climatic and other environmental changes. Methods & Materials: The analysis of the historical and present data regarding the presence, abundance and distribution of different vector species in Romania in correlation with the environmental, social and economic conditions led to the evaluation of the risk evolution of malaria re-appearance and the main factors involved. The entomological data were integrated with earth observation data obtained by spatial technologies and mapped to put in evidence the stratification of the present risk areas of malaria re-emergence. Results: The general level of malaria re-emergence risk varied in Romania. The risk was low after eradication linked to the low densities of vector populations because of the climatic conditions maintained in usual limits and intensive agriculture on large uniform areas. The risk gradually increased after 1990 linked to the high abundance of vector populations as before malaria eradication because of the global climate change and the land use change in Romania leading to the fragmentation of the habitat in the agricultural areas produced by the resuming to the traditional work on small private pieces of land. The present risk areas of malaria re-emergence are mapped. They generally overlap the former malaria stratification areas in Romania in accordance to the distribution of different vector species in the landscape. The new aspects are linked to the present environmental changes. Anopheles atroparvus, the main vector in Romania, has higher abundant populations and its distribution extended over all the risk areas. Anopheles daciae, possible malaria vector, has an extended distribution and higher densities than Anopheles messeae everywhere. Conclusion: The malaria re-emergence risk maintains in Romania in conditions of the climate and other environmental changes. There is the need of the permanent surveillance of the factors influencing this risk to prevent and control malaria re-appearance. [ABSTRACT FROM AUTHOR]