Introduction: This study aims to evaluate the socio-demographic and clinical risk factors associated with mortality from severe malaria in children, a prevalent issue in endemic areas. Methods: A retrospective analysis was conducted on clinical and demographic data concerning children affected by severe malaria. The examined variables include age, sex, type of living environment, distance to the hospital, as well as clinical comorbidities and treatment responses. Results: The observed mortality varies across age groups, showing a death rate of 19.7% among children under 11 months and 54.4% among those aged between 12 and 59 months. Male sex and urban residency are correlated with better survival rates. Additionally, a distance of less than or equal to 5 km from the hospital also favors survival. Furthermore, comorbidities such as bacterial infections and HIV/AIDS, along with conditions like anemia and neurological manifestations, significantly increase the risk of mortality. Resistance to antimalarial treatments is identified as an exacerbating factor. Discussion: These findings highlight the need to direct interventions toward high-risk children, particularly those with co-infections and severe clinical complications. Effective prevention policies alongside improved access to appropriate care could further contribute to reducing malaria-related mortality.