Introduction <p>The rising number of the aging population in Africa poses a new threat to the already strained healthcare system in this region. Aging predisposes the elderly to mental decline, cancer, chronic respiratory diseases, cardiovascular diseases, and diabetes. While these diseases are not exclusive to the elderly, they are certainly prevalent in this population. Radiopharmaceutical services in nuclear medicine help in the management and diagnosis of these diseases, but the specialty is faced with a myriad of challenges in Africa which hampers the efficient provision of this service to the needy.</p> Purpose <p>This study aims to determine the challenges affecting radiopharmaceutical services access in English-speaking African countries.</p> Method <p>A cross-sectional, mixed method approach was used.</p> Results <p>Eight main themes were identified: (1) high cost-related challenges (2) effects of electrical power outages, (3) lack of knowledge about radiopharmacy, (4) inadequate radiopharmaceutical infrastructure, (5) unreliable service from African radiopharmaceutical manufacturing companies, (6) national policy-related challenges, (7) radiopharmaceutical equipment-related challenges, and (8) staffing-related challenges.</p> Conclusion <p>Radiopharmaceutical access in English-speaking African countries varies significantly from country to country. South Africa is the only country in this region that commercialize radiopharmaceuticals, it is also the only country in the region with the largest number of nuclear medicine facilities(109). Nuclear medicine facilities in some ountries only operate once every two months to try reduce the cost of service to patients.There are 11 countries in Anglophone Africa that do not have access to the service at all.</p>