BACKGROUND Placental malaria is one of the complications of malaria in pregnancy and is associated with poor pregnancy outcome. Demonstration of its prevalence, risk factors and its associations with pregnancy outcome will help us modify the measures in the prevention of malaria in pregnancy and strengthen the effective preexisting preventive measures in our community. It will also make us understand the burden of this malaria in pregnancy. More so, there is paucity of studies of placental malaria in our environment using histology which is the gold standard. AIM: To identify the risk factors for placental malaria and its associations with pregnancy outcome. STUDY DESIGN AND SETTING: This is a cross sectional study carried out at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South East, Nigeria between 1ST August, 2012 and 31st January, 2013. MATERIALS AND METHODS: A cross section of pregnant women with singleton fetus of at least 28 weeks of gestation who presented to the labour ward for delivery was recruited for the study. The following data were obtained from those who met the inclusion criteria: phone number, age, parity, gestational age, the booking status, educational level and husband’s occupation. The history of intermittent preventive therapy (IPT), HIV status, Blood group and Haemoglobin genotype were also obtained. Before delivery, blood sample was collected for packed cell volume (PCV) estimation, then after delivery a sample of placenta was collected for histology and the baby weighed within 12hours of delivery. At seventh day of delivery, the mothers were contacted through phone calls and the state of the baby noted. All these data were recorded in proforma. Descriptive analysis of the results was done using the statistical package for social sciences (SPSS) version 16. Student-t- test and Odd ratio were used for univariate analysis while logistic regression was used for multivariate analysis and the results expressed in adjusted Odd ratio and confidence interval (C.I) ;and P-value <0.05 was taken as significant level.