Rapid diagnostic test (RDT) results are the foundation of both case management and malaria surveillance across sub-Saharan Africa. However, RDT results may be misrecorded in health facility registers, either unintentionally or deliberately, for example, to justify treatment based on clinical judgment. We conducted a multi-country evaluation to quantify the extent of RDT misrecording and identify factors associated with recording and reporting accuracy. This report summarizes the study’s methods, key findings, and implications for improving malaria RDT data quality.