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Background & objectives: The effect of aqueous extract of Tinospora cordifolia, an immunomodulatorwith antimalarial activity along with chloroquine was studied in the treatment of three cases ofhyper-reactive malarious splenomegaly in District Hospital, Daltonganj town, Jharkhand, India. Thesecases were partial/slow responders to the conventional antimalarial drug chloroquine.Methods: Aqueous extract of T. cordifolia (500 mg) was added to chloroquine (CQ) base (300 mg)weekly and CQ prophylaxis was observed up to six months. Improvement was gauzed by measuringspleen enlargement, Hb, serum IgM and well-being in three cases of hyper-reactive malarious splenomegaly.Results: Addition of extract of T. cordifolia for the first six weeks to chloroquine showed regressionof spleen by 37–50% after six weeks and 45–69% after six months from the start of treatment. Likewisedecrease in IgM and increase in Hb as well as wellbeing (Karnofsky performance scale) were observed.Conclusion: The results of the present study paves a new sight in the treatment of hyper-reactivemalarious splenomegaly, however, large-scale trial is required to confirm the beneficial effect of T.cordifolia extract in combination with chloroquine.