There is increasing interest in using spatial decision support tools to enhance operational aspects of malaria elimination programmes. To date, many such tools have been developed in pilot or trial settings but haven’t been scaled up for routine use in national programmes. Existing tools, such as DHIS2, have limited functionality. Additionally, there has been great progress in developing spatial modelling and prediction methods and applying them in a research setting, but limited translation to real-world use. In this presentation, I will describe these advances, outline the operational and programmatic needs that can be enhanced by spatial decision support tools and describe the challenges for scaling up and implementation.