According to the WHO, unmanaged insecticide resistance may lead to increases in malaria-related mortality and morbidity. Bangladesh, having made significant progress in malaria control efforts, has recently seen an upswing in malaria cases-58% of which occurred in Bandarban district. Toward identifying entomological drivers of increased malaria, an entomological survey including Anopheles susceptibility to the insecticides in use was conducted in Bandarban. Anopheles vagus, the primary vector of malaria, was found to be resistant to both permethrin and deltamethrin-with only 29% and 55% mortality at 30 minutes, respectively. Intervention strategies in this area-all based on pyrethroids, may need to be reevaluated toward closing this gap in protection and increasing intervention efficacy.