Purpose of Review Despite global incidence, considerable morbidity, and diverse triggers, CU is poorly characterized amongst diverse African populations. This systematic review aims to describe available African CU studies and unmet needs. Recent Findings Overall 221 publications were screened and 29 were eligible for full review. These publications represented only 12 of 54 African countries, with 38% from Nigeria. Most publications described CU within the context of dermatology out-patient clinics(21/29), with a CU prevalence of 0.03-10.4%. Two studies detailed CU demographics, with a female predominance and median age of 30-40 years. CU patients reported variable associations with infections, including T.canis(Egypt), and H.pylori(Nigeria and South Africa), with other risk factors including foods, food additives, and low vitamin D levels. UAS was reported for < 100 CU patients, and only two studies detailed and CU co-morbidities, while none addressed other patient-reported outcome or quality-of-life measures, treatment access and/or efficacy. Summary Despite considerable disease prevalence, CU is poorly detailed in African populations. Further CU studies are required to detail phenotypes, disease severity and describe treatment use and unmet needs.