We report a case of Plasmodium vivax infection manifested as severe thrombocytopenia, bilateral hydronephrosis, and hypotension in a returning traveler from a malaria–endemic area in Venezuela. While most of the efforts to prevent malaria in travelers focus on the life‐threatening consequences of Plasmodium falciparum malaria, nonimmune travelers who encounter infection with P vivax may also develop serious complications. This case highlights the importance of preventing malaria cases among nonimmune or semi‐immune individuals traveling to P vivax–endemic areas.