The present study was undertaken to evaluate the cost-effectiveness of lambdacyhalothrin treated nets in comparison with conventional DDT-spraying as a method of malaria control according to the patients’ perspective among migrant populations in a high-risk area along the Thai-Myanmar border in Thailand.  Ten hamlets comprising 243 houses with 948 inhabitants were given only treated nets. Twelve hamlets comprising 294 houses and 1,315 inhabitants represented the DDT-treated area and another six hamlets with 171 houses and 695 inhabitants served as controls.  Information as to consumer costs was obtained by interviewing 3,214 patients seeking care at all levels of the health care system in the study area.  Analysis showed that the impregnated-net program was more cost-effective than DDT-spraying program or surveillance alone (US$0.59 vs US$0.74 vs US$ 0.79 per 1 case of prevented malaria).  We conclude that in a high-risk area such as along the Thai-Myanmar border in western Thailand, integrating the use of impregnated nets with large-scale primary health care programs is likely to constitute the most cost-effective method for controlling malaria according to the patients’ perspective.