In the last decade of the nineteenth century, malariology emerged as the most prestigious and intellectually exciting field in the new discipline of tropical medicine. The disease’s complexity and resistance to conventional public health strategies posed a major challenge to doctors and scientists. Plague measures and social hygiene had no effect in curbing malaria, and the disease proved difficult to classify. The case of Italy, and the malaria eradication program of 1900-1962, furnished a model for other efforts across the world. In evaluating the Italian campaign, it is important to distinguish between valuable lessons and warnings for future efforts, and in particular to account for the diversity of strategies responsible for its success.