Africa spans the hemispheres from temperate region to temperate region, has a long history of hominin evolution and yet has a relatively poorly understood Quaternary climate history. Speleothems, as archives of terrestrial hydroclimate variability, can help reveal this history, and here we review the progress made to date, with a focus on the first version of the Speleothem Isotopes Synthesis & Analysis (SISAL) database. The geology of Africa has limited development of large karst regions to four areas - the northern and eastern coasts bordering the Mediterranean and the Indian Ocean, west Africa and southern Africa. Exploitation of the speleothem palaeoclimate archives in these regions is uneven, with long histories of research in South Africa and Morocco but no investigations elsewhere e.g. West Africa. Consequently, the evidence of past climate change reviewed here is irregularly sampled in both time and space. Nevertheless, we show evidence of migration of the monsoon belt, with enhanced rainfall during interglacials observed in northeast Africa, southern Arabia and the northern part of southern Africa. Evidence from East Africa also indicates significant centennial scale rainfall variability. In northwestern and southern Africa precession and eccentricity influence speleothem growth, largely through changing synoptic storm activity.