ABSTRACT: To identify the differences in health-seeking for childhood malaria treatment, between urban and rural communities in Nigeria, with a view to providing information to policy makers that will be used to improve malaria control. Quantitative and qualitative research methods were employed in eliciting information. A pre-tested structured questionnaire was administered to 1200 caretakers of children under 5 years who had malaria 2 weeks prior to the survey period. Focus group discussions were held with mothers and in-depth interviews with health care providers. Health-seeking for malaria, differed significantly between rural and urban mothers. While majority (64.7%) of urban caretakers patronized private/government health facilities, most (62%) of their rural counterparts resorted to self-treatment with drugs bought over-the-counter, from patent medicine vendors. Hospitals were geographically more accessibility to urban than rural dwellers. Rural mothers only go to hospital when the problem persists or becomes worse, which results in delay in seeking appropriate and timely care. Urban and rural mothers differed in their responses to childhood fevers. Training drug vendors and caretakers are important measures to improve malaria control. Health facilities with good quality services and readily available drugs should be provided.