Introduction: Cerebral Malaria (CM) and Black Water Fever (BWF) are examples of severe malaria. Severe malaria has a mortality rate of > 5% and increases the risk of death by 50%. According to WHO, the first line therapy for severe malaria is parenteral artesunate. However, in rural areas such as Waingapu, East Sumba, parenteral artesunate is not always available, so oral anti-malarial drugs are used as a substitute treatment. In this case, we present an adult case with Cerebral Malaria and Black Water Fever who responded well to oral anti-malarial. Case Report: A 38 year old man, with complaints of decreased consciousness starting with fever symptoms 4 days before hospitalization, accompanied by chills, cold sweat, headache, muscle aches and decreased appetite. Blackish red urine (coca-cola colored urine). The patient was treated in the ICU for 2 days and given DHP therapy for 3 days, because enteral anti-malarials were not available. On the third day of treatment the patient showed clinical improvement. Conclusion: DHP oral anti-malarial therapy and supportive therapy provided good results in this patient