The year 2020 made 52 years since the first report of Lassa fever (LF) outbreaks from Nigeria, but what progress has been made in its control? We sought to answer this through an epidemiologic analysis of the temporal and spatial trends of the outbreaks from 1969 to 2020. The analysis showed an overall strengthening of the outbreaks, hallmarked by the change from irregular to regular annual and from limited local to nationwide outbreaks, while there was a sharp contrast between the upward trend in case numbers and downward trend in case fatality. Pending the availability of effective vaccines, greater effort is required to reverse the upward trend in case numbers and sustain the downward trend in case fatality. We discuss the factors associated with the observed trends as well as the prerequisites for further improvements.