The APACHE II (Acute Physiology and Chronic Health Evaluation) severity-of-disease classification system was used to stratify the prognosis of 72 adult patients with cerebral malaria. Overall mortality was 13.89%. With the cut-off point at a score of 24, the APACHE II score stratified the patients' mortality outcome with 95.8% accuracy. High APACHE II score, deep unconsciousness, acute renal failure and acidaemia were identified as poor prognostic factors. We suggest that the APACHE II system is useful for stratifying the prognosis of group outcome in cerebral malaria patients.