Background: Mali is among the countries with the highest malaria burden worldwide, accounting for 3.1% of global malaria cases, 2.4% of global malaria-related deaths in 2023, and 6.6% of malaria cases in West Africa. The aim of this study was to describe the epidemiological and clinical profile of severe malaria among children aged 1 month to 15 years admitted to seven hospital facilities in Mali. Methods: We conducted a descriptive cross-sectional study among children aged 1 month to 15 years hospitalized for severe malaria between January and December 2024 in seven hospitals across Mali: Fousseni Daou Hospital (Kayes, first administrative region), Regional Hospital of Koulikoro (second administrative region), Sikasso Hospital (third administrative region), Nianankoro Fomba Hospital (Ségou, fourth administrative region), Sominè Dolo Hospital (Mopti, fifth administrative region), Regional Hospital of Gao (seventh administrative region), and Gabriel Touré University Teaching Hospital (Bamako District). Results: The highest frequency of severe malaria was recorded in Koulikoro (78.9%), followed by Gao (47.8%). Children under five years of age constituted the majority of cases in most hospitals, and males predominated in all study sites. Most admissions occurred during the rainy season, with a peak in October. Severe malarial anemia was the predominant clinical presentation in most hospitals, reaching 93.9% in Koulikoro and 63.5% in Gao. In contrast, neurological severe malaria predominated in Mopti (42.1%) and Sikasso (38.4%). The highest case-fatality rate was observed at Gabriel Touré University Teaching Hospital in Bamako (15.1%), whereas the lowest was recorded in Koulikoro (3.0%). Conclusion: Severe malaria remains highly prevalent across all regions of Mali. Strengthening malaria prevention strategies could contribute to reducing the persistently high case-fatality rates observed in hospital settings.