AIM: To conduct a retrospective analysis of the incidence of malaria episodes in the Astrakhan region from 2002 to 2022 in relation to climatic and social factors in order to provide the evidence for development of effective preventive measures. MATERIAL AND METHODS: An observational study. We performed correlation analysis to study associations between the spread of malaria and climatic and social factors in 2002–2022 in the Astrakhan region. The analysis was based on the data obtained from reporting forms of the Center for Hygiene and Epidemiology in the Astrakhan Region and Rospotrebnadzor in the Astrakhan region. Statistical processing of the data was carried out using Microsoft Office Excel tables (Microsoft, USA) and BioStat Professional 5.8.4. RESULTS: A decrease in the number of malaria cases in the Astrakhan region over the study period was a positive trend, which indicates the importance and effectiveness of measures to combat this serious disease. CONCLUSIONS: It is necessary to continue working in this direction in order to ensure the safety and well-being of the population in relation to the reported imported cases of malaria in the region.