Although it has been three centuries since cinchona bark was introduced into European medicine for the treatment of malaria, and it has been almost a century since the four alkaloids - quinine, quinidine, cinchonine, and cinchonidine - the active constituents of the bark were discovered. There are still numerous problems associated with the use of the cinchona bark and its constituent in malaria. Even though Quinine remains a very important anti-malarial drug almost 400 years after its effectiveness was first documented. However, its continued use is challenged by its poor tolerability, poor compliance with complex dosing regimens, and also the availability of more efficacious anti-malarial drugs has led to a decreased use of quinine for treating malaria. This article reviews the decreased use of quinine in treating material and why there still being used despite the numerous problems associated with the use of cinchona.