A case of imported severe falciparum malaria with spontaneous splenic rupture was reported in this paper. The patient, an African migrant worker, developed hemolytic anemia, sepsis, thrombocytopenia, coagulation dysfunction, liver failure, renal insufficiency, electrolyte disturbance and other clinical manifestations after returning to the local area. Plasmodium falciparum was found by peripheral blood smearscopy and was diagnosed as severe falciparum malaria. After standardized anti-malaria treatment, plasma exchange + cytokine adsorption therapy, the establishment of “forewarning–forewarning–prevention–emergency” predictive nursing management model, the establishment of an integrated nursing team, the division of medical care is clear, professional knowledge is complementary, after three months of regular follow-up, the patient has no malaria recurrence, no refire, the function of all organs returned to normal.