<p>Occupational stress is a pervasive issue globally among informal metal fabrication employees, with significant consequences for mental health. The review aims to understand occupational health stress and its psychological outcomes among informal metal fabrication workers in Southern Africa. Literature used during the review was wrangled from databases which included Google scholar, Scopus and PubMed. The review used PRISMA methodology for inclusion and exclusion criteria for selection of articles were 82 articles were found relevant. The review did an in-depth analysis of the contributing factors of occupational stress which included high job demands, inconsistent remuneration, inadequate resources and interpersonal conflicts. Furthermore, the study examined the effects of occupational stress that included behavioral outcomes, physical outcomes, emotional outcomes and cognitive outcomes with specific focus on mental health conditions such as anxiety, depression and burnout. Practical interventions to manage occupational stress employee focused interventions, workplace focused interventions, policy and community level interventions. Various laws governing worker well-being which included Factories and Works Acts from different countries in Southern Africa, Labour Acts and Occupational Health and Safety Policies. The review made recommendations for the informal metal fabrication industries to prioritize worker safety so as to ensure worker well-being, including mental health through offering training, safe work environments and personal protective equipment. Southern African governments and policy makers should make policies specifically tailored for the informal metal fabrication industries to ensure worker safety and address psychological hazards. There is a need for governments to fund occupational stress-related research and development (RD) to cover the dearth of literature on mental health in the informal metal fabrication industries.</p>