Objective To analyze the epidemiological characteristic of malaria and the updates of malaria elimination in China so as to provide evidence-based reference for facilitating the National Malaria Elimination Program. Methods The malaria epidemic data in 2018 were collected from 31 provinces/municipalities/autonomous regions (Taiwan, Hongkong and Macao regions not included) in China through Malaria Annual Reporting System, and analyzed using Microsoft Excel 2010 software. Results Total 2 678 malaria cases were reported from 796 institutions in China in 2018, which is decreased by 6.4% compared to the cases reported in 2017 (2 861 cases). The reported cases included 2 518 Chinese (94.0%) and 160 foreigners (6.0%). Most of the cases fell into the age range of 20-59 years (89.2%, 2 390/2 678) with a male-to-female ratio of 12.9 : 1. There were 397 cases infected with Plasmodium vivas (14.8%, 397/2 678), 1 765 infected with P. falciparum (65.9%, 1 765/2 678), 83 P. malariae(3.1%, 83/2 678), 376 P. ovale (14.0%, 376/2 678), 52 cases of mixed-infection (1.9%, 52/2 678) and 5 clinically diagnosed cases (0.2%, 5/2 678). No indigenous case was found while 2 671 (99.7%, 2 671/2 678) were identified as imported cases, 4 cases of introduced cases, 2 induced cases and 1 long-term dormant case. The top 5 provinces with highest number of malaria cases were Guangxi (254, 9.5%), Jiangsu (243, 9.1%), Shandong (233, 8.7%), Sichuan (221, 8.3%) and Yunnan (213, 8.0%). Total 117 cases with severe clinical symptoms were reported (4.4%, 117/2 678) from 15 provinces/municipalities/autonomous regions with 7 deaths (0.3%, 7/2 678) from 6 provinces/municipalities/autonomous regions. The 1-3-7 approach was implemented nationwide with good performance: all cases were reported within 24 hour (1 day) after diagnosis, 93.0% (2 491/2 678) of the cases were epidemiologically investigated within 3 days, and 2 250 sites with case identified were investigated and prevention measures were performed within 7 days. Conclusion Malaria was close towards elimination in China with no indigenous case reported for successive two years in the whole country from 2017-2018, however, more attention should be paid to the imported cases of malaria including the national surveillance and case management.