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<p>Abstract</p> <p>Background</p> <p>Malaria remains a significant health problem in Bangladesh affecting 13 of 64 districts. The risk of malaria is variable across the endemic areas and throughout the year. A better understanding of the spatial and temporal patterns in malaria risk and the determinants driving the variation are crucial for the appropriate targeting of interventions under the National Malaria Control and Prevention Programme.</p> <p>Methods</p> <p>Numbers of <it>Plasmodium falciparum</it> and <it>Plasmodium vivax</it> malaria cases reported by month in 2007, across the 70 endemic <it>thanas</it> (sub-districts) in Bangladesh, were assembled from health centre surveillance reports. Bayesian Poisson regression models of incidence were constructed, with fixed effects for monthly rainfall, maximum temperature and elevation, and random effects for <it>thanas</it>, with a conditional autoregressive prior spatial structure.</p> <p>Results</p> <p>The annual incidence of reported cases was 34.0 and 9.6 cases/10,000 population for <it>P. falciparum</it> and <it>P. vivax</it> respectively and the population of the 70 malaria-endemic <it>thanas</it> was approximately 13.5 million in 2007. Incidence of reported cases for both types of malaria was highest in the mountainous south-east of the country (the Chittagong Hill Tracts). Models revealed statistically significant positive associations between the incidence of reported <it>P. vivax</it> and <it>P. falciparum</it> cases and rainfall and maximum temperature.</p> <p>Conclusions</p> <p>The risk of <it>P. falciparum</it> and <it>P. vivax</it> was spatially variable across the endemic <it>thanas</it> of Bangladesh and also highly seasonal, suggesting that interventions should be targeted and timed according to the risk profile of the endemic areas. Rainfall, temperature and elevation are major factors driving the spatiotemporal patterns of malaria in Bangladesh.</p>