An ecoregional approach to the classification of malaria in the neotropics region can give health personnel a new prespective on how to manage malaria control programs. We propose an ecoregional classification based on vector distribution and important environmental determinants, including vegetation type, rainfall patterns, mean temperatures, elevation, and geomorphology. The following 5 ecoregions are described: (1) coastal, (2) piedmont, (3) savanna, (4) interior lowland forest, and (5) high valley. Subregional differences are classified when appropriate. Because human activities and extensive changes in land use usually leads to increased human-vector contact and alter local vector distribution and abundance, it is important that these changes be considered in the classification of vector ecoregions. Using this approach, risk areas can be classified as to the presence and potential abundance of particular vectors. Then, in combination with other components of malaria transmission (e.g., migration, cultural practices, living conditions), areas for surveillance and intervention can be prioritized. It is hoped that this forum will be a catalyst for discussion, future research, and the development of ecologically orientated malaria control programs.