Background <p>Climate change represents an urgent global health and environmental challenge, with youth in Africa, who account for over 60% of the continent’s population, being disproportionately affected due to limited adaptive capacities, inadequate education, and fragile mental health systems. Climate change literacy, defined as the ability to obtain, process, and apply climate-related information, is crucial for fostering awareness, adaptive behaviours, and psychological resilience among students. Simultaneously, growing evidence points to the mental health consequences of climate change, including anxiety, distress, and emotional exhaustion. Given the growing urgency to address these converging challenges, a comprehensive understanding of the existing evidence is needed. This scoping review aims to systematically map the literature on climate change literacy, perceived health effects, and climate-related mental health outcomes among African students. It seeks to identify key themes, highlight gaps in knowledge, and inform future research, educational programming, and policy interventions aimed at building climate resilience among African youth.</p> Methods <p>This scoping review followed the PRISMA-ScR guidelines. A comprehensive literature search was conducted across seven databases: PubMed, Scopus, Embase, Web of Science, ScienceDirect, AJOL, and PsycINFO. Peer-reviewed primary studies published between January 2014 and March 2024 were included. Eligible studies involved African students at primary, secondary, or tertiary education level and reported on at least one of the following: climate change literacy, perceived health impacts of climate change, or mental health outcomes related to climate change. Two reviewers independently screened articles, extracted data, and charted key findings. The results were synthesized both numerically and thematically, with a narrative summary used to integrate and interpret the evidence.</p> Results <p>A total of 5,256 records were retrieved, and finally 23 studies included for final analysis. The 23 included studies, spanning 12 African countries and involving 20,531 participants, revealed considerable variability in students’ climate change literacy, health perceptions, and mental health responses. While university students generally exhibited moderate to high knowledge and positive attitudes, misconceptions and limited behavioural engagement persisted, particularly among primary and secondary school students. Students perceived climate change as a driver of vector-borne diseases, malnutrition, respiratory illnesses, and heat stress. Mental health impacts, including anxiety, depression, and emotional distress, were reported in several studies, yet remain underexplored. Key barriers to climate literacy and engagement included curriculum gaps, limited institutional support, and socio-cultural misconceptions, whereas facilitators included media exposure, peer dialogue, and experiential learning opportunities.</p> Conclusion <p>This scoping review reveals substantial variability in climate change literacy, perceived health effects of climate change, and mental health outcomes of climate change among African students. While university students generally show higher awareness and engagement, misconceptions, weak curriculum integration, and limited behavioural action persist. Students increasingly recognize climate-related health risks such as vector- and waterborne diseases, malnutrition, and heat-related illnesses yet mental health impacts, including anxiety and emotional distress, remain underexplored. The review underscores the need for standardized, age-appropriate climate education integrated with public and mental health content. It calls for educator capacity building, experiential learning, institutional mental health support, and student empowerment through climate action platforms. A multi-sectoral approach is essential to develop informed, resilient, and engaged African youth to lead sustainable climate solutions.</p> Trial registration <p> A protocol for this scoping review was pre-registered with the Open Science Framework (OSF) (link: <a href="https://osf.io/mrbfn">https://osf.io/mrbfn</a>).</p>