The African coastal zone consists of the east, west, central, southern and Mediterranean coastal areas and comprises many port cities, including the cities of Durban in South Africa, Lagos in Nigeria and Mombasa in Kenya, the cities used in our illustrative case descriptions. Coastal areas in Africa are home to the highest concentration of the Continent’s human populations, with increasing burden of urban migrations, and host to diverse industries. It is now well established that all coastal locations are at risk of climate change effects, such as accelerated sea-level rise, increased global temperatures and changing storm frequencies. The impacts of climate change are likely to worsen many geological hazards that African coastal areas already face—increased shoreline erosion and sediment discharge, coastal flooding, and water pollution. But, according to the Lancet, “… the impact of changing climate on health is the most serious health threat of the twenty-first century”. The main objective of this Chapter is to present a synopsis of our present understanding of the scale, frequencies and trends of some hazardous geometeorological processes impacted by climate change in African coastal cities, and the effect of these processes on population health and food systems. By means of a systematic review based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol and backed by long-term documented medical registry data on probable climate induced maladies, an attempt is made to establish and document recent trends in research largely during the last decade on the effects of climate impacted geological processes on human health, and food systems in African coastal cities. Gaps in knowledge (italicised) are identified, and directions for future research are proposed. Such an approach, it is hoped, would enable the development of improved policies and interventions for mitigating the health impacts (of these processes) and their adverse effects on food systems, as well as buttress the evolution of tangible and effective coping strategies of affected populations in African coastal cities.