Background Patient satisfaction is as an important measure of program assessment and health system performance. In our study, we assessed patient's satisfaction with malaria care among pregnant women (PW) and mothers of children less than five years of age (MU5) in Ibadan, Nigeria. Methods A cross-sectional design, patient satisfaction with malaria care was assessed among 1,373 participants (818 PW and 555 MU5) with the anti-malarial care they received in a comprehensive hospital in Ibadan,

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... ria. Data on patient satisfaction was obtained using a validated eighteen-item questionnaire (PSQ-18) and analyzed using the standard satisfaction scales and quantitative scores. Results Overall, more than half of the participants (79.5% of PW and 78.8% MU5) were well satisfied with malaria care. The least satisfaction i.e., 41.4% among PW (mean satisfaction score = 3.06±1.2) and 45.1% (mean 3.16±1.3) among MU5 was reported on the clinical technical quality of (Sometimes doctors make me wonder if their diagnosis is correct). Furthermore, general satisfaction (based on satisfactions with technical quality, inter-personal attitude, communication, cost, accessibility or convenience and time spent with the doctor) was inversely associated with parity of PW (OR for PW with one child = 0.51, 95% CI: 0.34-0.75 with reference to pregnant women who have had more than one child) in multivariate analyses. Among MU5, general satisfaction was associated with extreme poverty (OR = for the poorest = 0.30, 95% CI: 0.10-0.90, with reference to the richest). Conclusion Socio economic status plays significant roles in mothers' satisfaction with health care access, level of care received and most importantly their prospective health seeking behaviour. Important aspect, such as patient's perception of being well treated by the health care provider should be a key consideration for formulate a patients' centred strategy to improve malaria cares in Oyo state and Nigeria at large.