The data on imported malaria and epidemiological investigation of individual cases reported in Xuchang City, Henan Province, were collected from the Infectious Disease Surveillance Reporting and Management System, and the Parasitic Disease Prevention and Control Information Management System from 2017 to 2023. The epidemiological characteristics and case diagnosis were analyzed. There were 65 malaria cases reported in Xuchang City, including 48 Plasmodium falciparum infections (73.8%), 10 P. ovale infections (15.4%), 2 P. malariae infections (3.1%), 3 P. vivax infections (4.6%) and 2 mixed infections (3.1%). The male-to-female ratio was 20.7∶1. The cases were mainly reported by districts of Jian’an (30.8%, 20/65), Yuzhou (26.2%, 17/65) and Weidu (18.5%, 12/65), and there was no apparent seasonal variation in distribution. The time interval P₅₀ between the onset and diagnosis of the cases was 2 days (P₂₅, P₇₅: 1 d, 4 d). The median time interval from onset to diagnosis for cases with and without a history of malaria was 2 days (1, 4), with no statistically significant difference (Z = -0.636, P > 0.05). The malaria diagnosis accuracy rate within 3 days after medical consultation was 83.1% (54/65). The proportion of malaria cases reported by provincial, municipal, and county (district) medical facilities in Xuchang City from 2017 to 2023 was 7.7% (5/65), 50.8% (33/65), and 41.5% (27/65), respectively. The proportion of initial diagnosis medical facilities at the provincial, municipal, county (district), and rural levels was 7.7% (5/65), 29.2% (19/65), 29.2% (19/65), and 33.9% (22/65), respectively (χ² = 7.999, P < 0.05) and their malaria diagnosis accuracy rates were 5/5, 17/19, 16/19, and 0 (0/22), respectively (χ² = 47.228, P < 0.01). The reported cases were all imported cases, mainly from Nigeria (20.0%, 13/65), the Democratic Republic of Congo (15.4%, 10/65), and Guinea (9.2%, 6/65) in Africa.