The concept of malaria elimination is to get rid of local transmission of malaria parasites in a defined geographical area. Among the measures required for malaria elimination is prompt and accurate diagnosis. Malaria diagnostic tools currently in use: clinical diagnosis, Malaria Rapid Diagnostic Tests (mRDT) and molecular diagnosis, have limitations. Clinical diagnosis can be used as first step in making prompt malaria diagnosis, but cannot confirm cases. Malaria RDTs satisfies the need for prompt diagnosis but has low accuracy in confirming cases. Accuracy of microscopy depends on making good blood films, and accurate film interpretation. Molecular diagnosis required for species-specific diagnosis of malaria parasites, and determination of genes that confers drug resistance to Plasmodium species is not available for routine use. As part of elimination efforts, there is development of mRDT kits that utilize urine or saliva instead of blood specimen, microscopy digital image recognition and different technologies for molecular diagnosis. So far, none of these diagnostic tools has satisfied the need for prompt and accurate diagnosis. It is therefore recommended that more than one diagnostic tool is needed for malaria elimination to be achieved in a given area. This will ensure early detection and treatment of cases, as well as prevent the re-establishment of transmission.