Up to the date variations of malaria pathogenesis between human populations signify important trouble facing scholars concerned with malaria pathology. Pathogen-associated molecular patterns may be one of the main keys to the well understanding of malaria mechanism and dissimilarity of clinical outcomes of the disease between people. Uric acid is regarded as a dangerous alarming metabolite, resulting from plasmodium activity inside infected red blood cells, furthermore, levels of uric acid correlate with the development of intracellular malaria parasites. Hypoxanthine resulting from the breakdown of haemoglobin by Plasmodium species is very important in malaria pathogenesis, because plasmodia use it as a nutrient and after rupture of schizonts the remaining of it is converted to uric acid due to the action of Xanthine oxidase, and that gave a strong linkage between malaria pigment density and severity of malaria infection. Uric acid is the main cause of arthritis which is one of the common clinical features of malaria, it induces the inflammatory response and many cytokines involved, genes related to hyperuricemia involved discrepancy of clinical outcomes between malaria patients.