This study analyzed national survey data from 12 sub-Saharan African countries to assess the timeliness of malaria treatment for children under 5. It found that overall, 63% of children received prompt antimalarial treatment within 24 hours of fever onset. Maternal education level, household wealth, and country of residence were key predictors of timely treatment access. Children with higher-educated and wealthier mothers and those living in Mozambique, Zanzibar, Malawi, Rwanda, Senegal and Tanzania were most likely to receive prompt and effective malaria treatment.