Malaria is one of the leading tropical diseases affecting majority of the rural population in Nigeria. This disease drains the insufficient income of rural dwellers and further reduces their socio-economic standards. This study examined the economic cost of malaria treatment to poor rural households selected from six communities in Enugu state using cost of illness approach. It found that ‘richest’ rural households on the average spentN6153 (28.41%) monthly while households from the poorest quintile spent 30.25% of their average monthly income on malaria treatment. This leads these households into large financial catastrophe forcing them to reduce other basic expenses. These poor households are likely to remain in poverty if measures are not taken to alleviate the situation. Policies that would consider the introduction of community-based health insurance scheme or reduction in user fees in the rural areas are recommended.