This study analyzes the epidemiological behavior of malaria on the Pacific Coast of the Department of Nariño, Colombia, over the period from 2003 to 2017. Using a descriptive and retrospective approach, we examined malaria case reports, focusing on incidence rates, species distribution, demographic characteristics, and temporal trends. The findings reveal a fluctuating pattern of malaria incidence, strongly influenced by environmental, social, and historical factors unique to the region. Plasmodium vivax was the predominant species, followed by Plasmodium falciparum. The highest incidence rates were observed among young adults and men, highlighting vulnerable population groups. Control strategies implemented during this period showed variable effectiveness, with some reduction in cases but persistent endemic transmission. The study underscores the importance of tailored public health interventions, continuous surveillance, and community engagement to effectively control malaria in this complex epidemiological setting. These insights contribute to understanding malaria dynamics in Colombia and support evidence-based policymaking to reduce disease burden