Malaria is currently one of the major diseases that cause significant morbidity and mortality in sub-Saharan Africa including Ethiopia. The public health and socio-economic impact of malaria is very huge in Ethiopia. It contributes highly to the country’s poverty and underdevelopment. Therefore, this study aimed to determine the prevalence of malaria and its associated risk factors among febrile patients at Gisa Health center, Dangila district Awi zone, Amhara region, North West Ethiopia. The study was conducted from mid-February 2024 to mid-March 2024 by inviting 422 febrile patients at Gisa Health Center. The study design was a health institution based cross-sectional. The sampling technique was used random sampling technique. The data collection method was using structured questions. In the present study, blood samples were collected from the selected study participants and examined microscopically (thin and thick blood smear) by trained laboratory technicians. The data were cleaned and analyzed by SPSS version 26.0. Chi-square and logistic regression analysis were used to assess the possible association between dependent and independent variables. Out of the total of 422 study participants, 180 (42.7%) were positive for malaria. The prevalence of P. falciparum, P. vivax and mixed were 26.3%, 12.1% and 4.3%, respectively. Multivariate logistic regression analysis revealed that age between 6-15 were 4-times more likely infected by malaria than other age groups (AOR= 4.47; 95% CI=1.99-10.07, p < 0.001) of malarial infection. Multivariate logistic regression analysis revealed that marital status unmarried was 6-times more likely infected within other marital (AOR=5.774; 95%CI = 2.138-15.59; p < 0.001. Among the potential risk factors; sleeping outdoor (AOR=4.004; 95% CI=1.91-8.39, p < 0.001) and absence of ITN use (AOR=6.56, 95% CI= 2.94-14.63, p<0.001) were independent predictors of malarial infection among the study participants in the study area. This high prevalence of malaria observed in this study area indicates that malaria remains a serious public health problem. Therefore further work should be done to minimize the prevalence and burden of malarial infection in the study area. The concerned bodies should design practical action plans for effective prevention and control of malaria in the study area. Keywords: febrile patients, Gisa health center, malaria, Plasmodium, Prevalence, Risk factors