Malaria has been considered to be eradicated from the French West Indies for over 25 years. In this report we describe a patient who was hospitalized and successfully treated in Paris for severe Plasmodium falciparum malaria after returning form a brief trip to Guadeloupe. Several modes of transmission are possible. Given the presence of a reservoir of Plasmodium falciparum gametocytes in the Haitian immigrant community and persistent breeding of Anopheles albimanus in the French West Indies, the most likely explanation is local transmission. This is the second case of malaria involving travelers to Guadeloupe to be reported within the last ten years and the first time that autochtonous transmission has been considered. Falciparum malaria should be included in differential diagnosis for patients presenting fever after returning from travel in the French West Indies, a highly popular tourist destination.