To optimize the funds devoted to health care, and to objectively assess the tools used in monitoring patients with cerebral malaria, we determined two parameters, care charges and direct costs due to hospitalization. During this longitudinal study conducted at the Albert Royer Pediatric Hospital in Dakar from October 15, 1991 to October 15, 1992 with 76 cases, malaria represented 5.2% of the febrile cases and 3.4% of the hospitalized cases. The lethality rate was 3.4%. Clinical features were not correlated with care charges and thus were not good indicators of worker's labor. The average cost of a cerebral malaria hospitalization was estimated at 35,710 F CFA (In October 1992, 1 F CFA = 0.02 FF). This cost is very high depending the limited resources of the region. Rapid and proper treatment of malaria cases may lead to a significant reduction of costs.