Purpose: Splenic rupture is a recognised complication of acute Plasmodium falciparum and P. vivax malaria, but the risk of splenic rupture in chronic asymptomatic infections is not known. In malaria-endemic regions, chronic parasitemia is common and associated with splenomegaly and structural changes that may reduce splenic integrity. Here, we assessed population level data to determine the association between chronic malaria and trauma-related splenic rupture requiring splenectomy. Methods: In Timika, Papua, Indonesia, we determined the proportion of individuals with asymptomatic peripheral parasitaemia by microscopy and polymerase chain reaction (PCR) in two complementary study cohorts aged ≥10 years. The first cohort, conducted between 2015-2021, comprised 33 patients undergoing trauma-related splenectomy at the local district hospital. The second cohort, conducted in 2013, comprised 1,807 participants in household survey of the general Timika population. Results: The prevalence of asymptomatic peripheral PCR-positive parasitaemia was 87.9% (29/33) in the splenectomised patients compared to 38.6% (697/1,807) in the general Timika population (adjusted Odds Ratio [aOR] = 10.0 [95%CI: 3.5-28.8], p<0.0001). The difference was greatest for chronic patent (microscopy-detectable) infections (aOR = 5.7 (95%CI: 2.8-11.7), and remained apparent when stratifying by infecting parasite species including for P. falciparum (aOR = 5.4 [95%CI: 2.5-11.9]) and P. vivax (aOR = 3.2 [95%CI: 1.2-8.6]). Conclusion: Patients undergoing trauma-related splenectomy are twice as likely to have chronic malaria than the general population, suggesting that chronic P. falciparum or P. vivax infection may predispose individuals to splenic rupture following trauma. Our findings point towards an additional consequence of chronic infection in endemic areas and adds to existing reasons to diagnose and treat chronic parasitemia, particularly in groups who are prone to trauma.