Of the seventy cases of cerebral malaria seen at the Duchess of Kent Hospital, Sandakan between January 1984 and June 1986, 57 (81.4%) were due to plasmodia falciparum and 13 (18.6%) were due to mixed p. vivax--p. falciparum infections. Mixed infection cerebral malaria was associated with a more severe anaemia and may carry a poorer prognosis. Indigenous children under five years of age are particularly at risk of death from mixed infections.