Severe malaria is a life-threatening medical emergency and requires prompt and effective treatment to prevent death. For this paper,the authors evaluated the management practices for severe malaria in Ugandan health facilities. The results show that management of severe malaria in Ugandan health facilities was sub-optimal. These findings highlight the challenges of correctly managing severe malaria in resource limited settings. Priority areas for improvement include triage and emergency care, referral practices, quality of diagnosis and treatment, availability of medicines and supplies, training and support supervision.