Food and nutrition security are Africa’s main human welfare and economic growth challenges. While some countries may produce or import sufficient food to ensure adequate food availability, malnutrition in all its forms remains prevalent. This chapter explores the intersection between food systems activities and prospects for safe food and healthy diets. It also examines the opportunities and challenges of food system transformation in Africa. The chapter is underpinned by a review of secondary literature in grey and academic formats. The findings show that poverty, inequality and unemployment underpin Africa’s food challenges. Besides insufficient food production capacity at the production level, much of the food produced or imported is lost across the food system chain due to contamination. The chapter concludes that transforming Africa’s food systems to ensure safe food and improve healthy eating on the continent requires a multifaceted blend of manifold interventions involving public and private sector food system role-players with a broad range of interventions aimed at food production, processing systems, and consumers. This will require political will, passion, expertise, and innovative thinking from all role-players in the supply chain, spanning from farm to table within households. Social policy-based interventions are also required to ensure that the poorest of society have adequate access to safe food to meet their healthy dietary needs.