Malaria is an urgent public health priority due to its high cause of morbidity and mortality. This study investigated the prevalence of malaria parasitaemia in Rivers State, Nigeria. Random sampling technique was used. A total of 1200 samples were collected; thick films (stained with Fields stain A&B) and thin films (stained with 3% Giemsa) were examined microscopically. Out of these samples, 530 (44.16 %) were infected, with total parasite density of 2107518/µl. Plasmodium falciparum was the only species found. The highest infection 61 (61%) was in General Hospital (GH) Abua with statewide infection, 61 (5.08%) and parasite density 248616/µl followed by GH Ahoada East, 59 (59%) with statewide infection of 59 (4.92%) and parasite density 203540/µl and the least was GH Isiokpo, 24 (24%) with statewide infection of 24 (2%) and parasite density, 137696/µl (p<0.05). Rivers West had the highest infection rate, 215 (53.75%) with statewide infection of 215 (17.92%) and parasite density, 802100/µl whereas the least was recorded in Rivers East 134 (33.5%) with parasite density 685600/µl and statewide infection of 134 (11.16%). Consistent statewide investigation and sustained awareness should be carried out to track progress and identify areas of data driven intervention needs for smart decisions to combat malaria.