Precision agriculture (PA) holds significant potential for optimizing agricultural production at reduced costs while preserving environmental resources using smart technologies. It represents a critical and urgently needed approach to addressing escalating poverty, food insecurity, and nutritional challenges in Southern Africa. Precision agriculture techniques ensure the optimal use of production inputs while contributing to substantial increases in agricultural output. However, the extent of adoption and implementation of PA in Southern Africa remains largely unknown. This study presents a systematic scoping review of literature on the progress, challenges, opportunities, and gaps in the application of PA in the region. Following PRISMA guidelines, a total of 58 articles from Southern Africa were retrieved from the Web of Science and Scopus databases and bibliometrically analyzed to address the study’s primary objectives. Results show that literature on PA in Southern Africa is generally limited. Nonetheless, the region has pioneered the implementation of several PA technologies and approaches, primarily in crops, soil, irrigation, rangeland, livestock, and pest and disease management. Most of these technologies have been applied on commercial farms, with limited documentation available for small-scale and small-holder farming systems. Expanding the adoption of PA will support the implementation of climate-smart agricultural practices and contribute to achieving the Sustainable Development Goals related to ending poverty, hunger, and food and nutrition insecurity in Southern Africa.