An evaluation was made of the diagnostic efficacy and utility of the Parasight-F test in diagnosing Plasmodium falciparum malaria, compared with conventional microscopy, particularly in severe and complicated cases. This study was designed as a prospective, case control hospital-based study. Febrile patients suspected to be suffering from malaria were selected randomly and were subjected to peripheral smear examinations (thick and thin) and Parasight-F tests till the required number of at least 30 cases of P. falciparum infection were identified, including at least 15 complicated cases. In addition 20 cases of P. vivax malarial infection as well as 20 healthy age and sex-matched individuals were taken as two control groups. The outcome measure was the number of cases with positive Parasight-F test results compared with conventional microscopy. Thirty-two patients with P. falciparum malaria were identified, with 15 severe and complicated cases. Peripheral smears were positive in 29 (91%) of these, while parasight-F test was positive in 31 out of 32 (97%) cases. Parasites were detected only by bone marrow examination in one case. Diagnostic sensitivity and specificity of peripheral smears for detecting falciparum infection were 90.6% and 100% respectively while that of the Parasight-F test were 96.8% and 100%, respectively (P>.05). The Parasight-F test has high sensitivity and specificity in diagnosing P. falciparum malarial infection, comparable to or even higher than microscopy exams, particularly in severe and complicated cases, with additional advantages of speed, simplicity and objectivity.