Malaria remains a leading cause of ill health in Africa and Nigeria. From the world malaria report, 2018 53 million annual cases in Nigeria (1 in 4 persons), contributing 25% global burden and 53% of cases in West Africa. In Nigeria alone, 81,640 deaths are recorded annually (9 deaths per hour), which accounts for 19% global malaria deaths (1 in 5 global malaria deaths) and 45% malaria deaths in west Africa. The Nigeria Malaria Strategic Plan (NMSP) 2014-2020 has as its goal-to reduce malaria burden to pre-elimination levels and bring malaria-related mortality to zero. In North-East Nigeria, malaria transmission is perennial with a marked seasonal peak from July to November each year. Since malaria is highly endemic in the north-east, increasing the burden on health resources and elevating the risk of morbidity and mortality among the affected population, particularly children under five who are one of the vulnerable groups, Seasonal Mass Chemo-Prevention (SMC) during the rainy season to reduce morbidity and mortality in emergency settings was deployed in 2018 and the results were enormous 6.5% reduction in fever cases and confirmed malaria, when compared with previous years in children under five who benefited from SMC as obtained from the study of effect of SMC on malaria morbidity conducted in Adamawa State in 2018. To achieve a better impact on malaria control, a combination of preventive measures (robust surveillance, indoor residual spray, using insecticide-treated nets), effective case management and improved capacity of personnel is recommended.