Africa is experiencing increasing water stress driven by rapid population growth, climate variability, accelerating urbanisation, and rising agricultural water demands. In many African countries, surface water remains the primary source of freshwater, but recently groundwater has become increasingly important. Managed Aquifer Recharge (MAR) has gained prominence as a sustainable approach to enhance water security by increasing groundwater storage, improving water quality, strengthening drought resilience, reducing flood impacts, and supporting climate change adaptation. Although MAR has been widely applied and documented globally, Africa’s diverse hydrogeological settings, variable climatic regimes, and complex socio-economic and institutional contexts present both unique opportunities and significant challenges for its implementation and scaling. In recent years, several African countries have initiated MAR pilot projects or integrated recharge enhancement measures into broader water resources management strategies. However, a comprehensive understanding of MAR implementation pathways, demonstrated successes, operational challenges, and the local factors influencing system performance remains limited. This review assesses the current state of MAR development in Africa, focusing on strategic objectives, recharge techniques, modelling and decision support approaches, water quality considerations, socio-economic dimensions, and published case studies. It further evaluates key limitations and emerging risks, including technical and data constraints, environmental and water quality concerns, institutional and governance barriers, financial limitations, and regulatory gaps. Finally, the paper proposes an integrated roadmap for advancing MAR across Africa, emphasising strengthened governance and policy frameworks, improved hydrogeological data and monitoring networks, climate-resilient planning, greater integration of Nature-Based Solutions, and the active involvement of communities in operation and long-term management.