Controlling malaria during pregnancy is a vital strategy in decreasing maternal and child mortality in Africa. There are data from clinical trials and program evaluations in stable transmission areas that show that intermittent preventive treatment (IPT) with two doses of sulfadoxine-pyrimethamine (SP) is safe, efficacious, and effective in preventing maternal anemia, placental parasitemia, and LBW. SP is also the first-line drug for the case-management of malaria in pregnancy. Resistance to SP, however, is increasing rapidly in East and Central Africa and compliance to the rescue treatment, 7-days of oral quinine, is low. There is an urgent need to find effective, safe and practical alternative drugs for the treatment of malaria in pregnancy. The synergistic antifolate combination chlorproguanil-dapsone (CD), has recently become available as a fixed combination caplet of 80 mg chlorproguanil and 100 mg dapsone (Lapdap™, GlaxoSmithKline, UK). It is inexpensive ($0.29 per treatment course), well tolerated, is given as single daily treatment doses for 3 days, and is effective in the treatment of drug-resistant falciparum malaria. CD however has good efficacy as salvage therapy of SP treatment failures in children and could play an important role in the case management of malaria in pregnancy. Given that the component drugs are both considered safe in pregnancy, it is expected that the combination will also be safe for use in pregnancy, but this has not been formally evaluated.