In the interaction of Plasmodium falciparum with human cells, sporozoite adheres to the receptor of the liver endothelial cell, then invades to liver. Merozoite binds to the surface of red blood cells, and invades to erythrocyte. The adhesion of membrane protein of the infected erythrocytes to the surface molecules of vascular endothelial cell in the vital organs leads to the obstruction of blood circulation eventually. The adhesion is mediated by interaction between parasite-derived ligands and the negative charged polysaccharides on the surface of host cells. This review is to discuss the molecular mechanisms in the host-parasite interactions.