BackgroundAnopheles stephensiis an efficient vector of bothPlasmodium falciparumandPlasmodium vivaxin South Asia and the Middle East. The spread ofAn. stephensito countries within the Horn of Africa threatens progress in malaria control in this region as well as the rest of sub-Saharan Africa.MethodsThe available malaria data and the timeline for the detection ofAn. stephensiwas reviewed to analyse the role ofAn. stephensiin malaria transmission in Horn of Africa of the Eastern Mediterranean Region (EMR) in Djibouti, Somalia, Sudan and Yemen.ResultsMalaria incidence in Horn of Africa of EMR and Yemen, increased from 41.6 in 2015 to 61.5 cases per 1000 in 2020. The four countries from this region, Djibouti, Somalia, Sudan and Yemen had reported the detection ofAn. stephensias of 2021. In Djibouti City, following its detection in 2012, the estimated incidence increased from 2.5 cases per 1000 in 2013 to 97.6 cases per 1000 in 2020. However, its contribution to malaria transmission in other major cities and in other countries, is unclear because of other factors, quality of the urban malaria data, human mobility, uncertainty about the actual arrival time ofAn. stephensiand poor entomological surveillance.ConclusionsWhileAn. stephensimay explain a resurgence of malaria in Djibouti, further investigations are needed to understand its interpretation trends in urban malaria across the greater region. More investment for multisectoral approach and integrated surveillance and control should target all vectors particularly malaria and dengue vectors to guide interventions in urban areas.