Background <p>Diabetes mellitus represents a growing public health crisis across Africa, with prevalence rates increasing due to urbanization, lifestyle transitions, and epidemiological transition. Despite numerous technological advances in diabetes management, including continuous glucose monitoring (CGM), access to these innovations remains limited across the continent.</p> Objective <p>This narrative review examines the current state, opportunities, challenges, and prospects of CGM technology in African diabetes care, with emphasis on the socioeconomic, infrastructural, and cultural factors influencing implementation.</p> Methods <p>A comprehensive review of peer-reviewed literature, clinical trials, and implementation studies from African contexts was conducted, incorporating evidence on CGM technology, diabetes epidemiology, healthcare systems, and policy frameworks across African nations.</p> Results <p>CGM technology offers substantial benefits for glycaemic control, complication reduction, and patient empowerment. However, widespread adoption in Africa faces significant barriers including prohibitive costs, limited healthcare infrastructure, supply chain challenges, inadequate healthcare workforce training, and sociocultural factors. Emerging clinical trials in South Africa, Kenya, and Malawi demonstrate feasibility and clinical benefits, though large-scale implementation remains constrained.</p> Conclusions <p>While CGM holds important potential at transforming African diabetes care, successful integration requires multisectoral collaboration, innovative financing mechanisms, capacity building, and feasible implementation strategies. Policy frameworks that support equitable access, regulatory harmonization, and sustainable scale-up models are essential for realizing CGM’s full potential across the continent.</p>