Irrigated urban agriculture (UA), which has helped alleviate poverty and increase food security in rapidly urbanizing sub-Saharan Africa, may inadvertently support malaria vectors. Previous studies have not identified a variable distance effect on malaria prevalence from UA. This study examines the relationships between self-reported malaria information for 3,164 women surveyed in Accra, Ghana, in 2003, and both household characteristics and proximity to sites of UA. Malaria self-reports are associated with age, education, overall health, socioeconomic status, and solid waste disposal method. The odds of self-reported malaria are significantly higher for women living within 1 km of UA compared with all women living near an irrigation source, the association disappearing beyond this critical distance. Malaria prevalence is often elevated in communities within 1 km of UA despite more favorable socio-economic characteristics than communities beyond 1 km. Neighborhoods within 1 km of UA should be reconsidered as a priority for malaria-related care.