Background: In Asia, Malaria-related hyponatremia incidence ranges between 37% to 57 percent and since the prevalence of malaria is high in India and hyponatremia is common yet unexplored complication associated with it, the present study was conducted with an aim to determine the prevalence of hyponatremia in severe malaria and its association with mortality. Material and Methods: The present cross-sectional study was carried for a duration of two years among 220 adult patients with severe malaria admitted to the wards and ICU in a tertiary care center. Patient-specific information was collected in a structured schedule and blood sample was collected for laboratory investigations after obtaining written informed consent. The power of serum sodium levels in predicting the mortality was evaluated by Receiver Operating Characteristics (ROC) curve. Results: The malaria rapid test kits results showed that 57.3% of plasmodium species was only P. falciparum. The prevalence of hyponatremia was higher among subjects with mixed infection (78.8%) as compared to P. falciparum group (52.4%). Also, the mortality rate was higher among subjects with mixed infection (14.9%) as compared to P. falciparum group (6.3%). The best cut-off for serum sodium in predicting mortality among severe malaria subjects, on charting the ROC was 126 mEq/L with sensitivity and specificity as 76.6% and 88.4% resp. Conclusion: Present study shows that in severe malaria, hyponatremia is a common electrolyte imbalance. Mixed malaria infection is more frequently and severely associated with hyponatremia than isolated falciparum malaria. As a result of our findings, we suggest that serum electrolytes be measured in malaria patients of all ages.