UK guidance recommends that all patients with falciparum malaria be admitted to hospital, although a number of cohort studies in the developed world demonstrate that outpatient treatment of falciparum malaria is feasible and safe in selected patients. We review the literature on outpatient treatment in developed countries and present local data from East London where a selected immigrant population were successfully treated as outpatients. Although it is premature to claim that outpatient treatment of falciparum malaria is safe in all selected patients, we conclude it is time for a large UK-based safety study or randomised trial to dispel the belief that all patients with uncomplicated Plasmodium falciparum must be admitted to hospital.