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Rapid population growth and poor waste management practice are among the main drivers of plastic pollution in modern times, thus making Africa a hotspot for plastic pollution both now and in the future. This study is a review of plastic pollution reports from the African aquatic environment with regard to causes, current status, toxicological implications and implications for ecosystem services. A total of 59 plastic pollution studies from 1987 to September 2020 were reviewed. They comprised 15 from North Africa (NA) (Algeria, Egypt, Morocco and Tunisia), six from East Africa (EA) (Ethiopia, Kenya, Tanzania and Uganda), 13 from West Africa (WA) (Ghana, Guinea-Bissau, Mauritania and Nigeria), and 25 studies from Southern Africa (SA) (South Africa). This shows that plastic pollution studies in Africa, according to the sub-regions, are in the order: SA > NA > WA > EA. High human population in the basins of African large aquatic systems is identified as the greatest driver enhancing plastic surge in the aquatic environment. The occurrence of plastics was mostly reported in the estuarine/marine environment (42 studies) compared to the freshwater environment (only 17 studies). Plastics have also been reported in the three compartments of the aquatic environment: water column, benthic sediment and animals. Zooplankton, annelids, molluscs, insects, fishes and birds were reported as bioindicators of plastic ingestion in the inland and coastal waters of Africa. Polyethylene, polyethylene terephthalate (polyester) and polypropylene were the common plastic polymers observed in the African aquatic environment. In situ toxicological implications of the ingested plastic polymers were not reported in any of the studies. However, reports from laboratory-controlled experiments showed that these polymers are deleterious to aquatic animal health. More research efforts need to delineate the plastic pollution status of the East, West and North of Africa. Furthermore, such studies are required to identify the plastic polymers and in situ ecotoxicological impacts of plastics on both animal and human health.