Objective To understand the laboratory detection capability of imported malaria before and after malaria elimination in Hubei Province. Methods Data of malaria cases reported in Hubei Province from 2017 to 2022 were collected from National Infectious Disease Surveillance Reporting and Management System. The blood samples and detection review record forms of malaria cases reported in Hubei Province from 2017 to 2022 were collected. A review of the blood smears and blood samples was conducted by the professional technicians from the Hubei Provincial Malaria Diagnosis Reference Laboratory to identify malaria parasites. The blood smears were reviewed using microscopic examination, and the preparation, staining, and cleanliness of the blood smears were evaluated. The blood samples were reviewed for Plasmodium nucleic acids using fluorescence quantitative PCR. Using the retest results from the Provincial Malaria Diagnosis Reference Laboratory as the standard to analyze and compare the detection results provided by the malaria laboratories at the city (prefecture) levels on the positive qualification rate, parasite species coincidence rate, blood smear qualification rate, and sample delivery timeliness before (from 2017 to 2019) and after (from 2020 to 2022) malaria elimination. Results From 2017 to 2022, 501 cases of imported malaria were reported in Hubei Province, with 409 cases reported from 2017 to 2019 and 92 cases reported from 2020 to 2022. The sample collection rate from 2017 to 2019 was 99.3% (406/409), with a sample qualification rate of 99.3% (403/406). From 2020 to 2022, the sample collection rate was 94.6% (87/92), with a sample qualification rate of 82.8% (72/87). Among the 501 reported cases, 451 were confirmed as malaria by provincial malaria diagnosis review. From 2017 to 2019, a total of 373 confirmed malaria cases were reviewed, including 261 cases of falciparum malaria (70.0%), 48 cases of vivax malaria (12.9%), 52 cases of ovale malaria (13.9%), and 12 cases of malariae malaria (3.2%); from 2020 to 2022, a total of 78 confirmed malaria cases were reviewed, including 34 cases of falciparum malaria (43.6%), 20 cases of vivax malaria (25.6%), 19 cases of ovale malaria (24.4%), and 5 cases of malariae malaria (6.4%). There was a statistically significant difference in the composition of the 4 types of malaria before and after malaria elimination (χ² = 20.037, P < 0.05). The median sample submission time was 3 days (0-16 d) from 2017 to 2019, with an average of 4 days. From 2020 to 2022, the median sample submission time was 4 days (0-224 d), with an average of 8 days. The sample submission time was longer in all regions after malaria elimination (χ² = 25.591, P < 0.05). The positive compliance rates of the reported malaria cases in Hubei Province from 2017 to 2019 and from 2020 to 2022 were 91.9% (373/406) and 89.7% (78/87), respectively (χ² = 0.452, P > 0.05). The parasite specie compliance rates were 88.7% (331/373) and 78.2% (61/78), respectively, with a higher parasite compliance rate before malaria elimination (χ² = 6.296, P < 0.05). A total of 75 cases were misdiagnosed by city (prefecture) level malaria laboratories from 2017 to 2019, with a misdiagnosis rate of 18.5% (75/406), including 33 cases of qualitative misdiagnosis and 42 cases of species misdiagnosis; from 2020 to 2022, a total of 26 cases were misdiagnosed, with a misdiagnosis rate of 29.9% (26/87), including 9 cases of qualitative misdiagnosis and 17 cases of species misdiagnosis. There was a statistically significant difference in the species compliance rate for falciparum malaria before and after malaria elimination (χ² = 4.571, P < 0.05). A total of 492 blood smears were reviewed from 2017 to 2019, with a slide preparation qualification rate of 85.2% (419/492), staining qualification rate of 83.3% (410/492), and cleanliness qualification rate of 85.8% (422/492). From 2020 to 2022, a total of 209 blood smears were reviewed, with a slide preparation qualification rate of 71.8% (150/209), staining qualification rate of 76.1% (159/209), and cleanliness qualification rate of 76.6% (160/209). There were statistically significant differences in blood smear preparation, staining, and cleanliness evaluations before and after malaria elimination (χ² = 17.213, 5.054, 8.842, all P < 0.05). Conclusion After the elimination of malaria, the number of imported cases in Hubei Province has decreased. The laboratory detection capability of malaria has reduced slightly but remains stable.