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The following is a case report of a woman who presented to the hospital with severe anemia with features of HELLP syndrome and initial slide for P.vivax negative but on constant observation and monitoring turned out to be a case of severe malaria caused by vivax species of malaria. Primigravida with 35week5day pregnancy was admitted with complaints of severe anemia and history of fever 14 days back. Initially 3 pint blood was transfused i/v/o severe anemia. Investigations revealed Hb-3gm% and platelet count 30, 000, LFT deranged, Hemolysis in peripheral smear, smear negative for malarial parasite. HELLP syndrome was in mind and this required termination but on repeat investigations and smear vivax was positive. Her platelet count kept deteriorating despite transfusions till antimalarial regimen was not started. Once smear positive the fastest antimalarial artesunate regimen with clindamycin was started and after 48 hrs. her counts improved. Overall 14 pints of platelets were transfused and patient delivered uneventfully with mild PPH at platelet count of 30, 000. Severe malaria is usually caused by p falciparum but recently reports of severe malaria caused by vivax is increasing and HELLP syndrome is an important differential diagnosis which needs to be excluded as management is entirely different.