Africa's health landscape is rapidly changing, requiring new solutions such as a focus on health literacy. However, there is currently a limited overview of the development and application of health literacy in African countries and societies. To inform progress, a scoping review was conducted, including a systematic literature search of research approaches, historical developments, geographic origins, target populations and settings, and topical interests. 336 articles were retrieved from six databases following PRISMA guidelines. Sources identified included reports, policy briefs, book chapters, and research publications. The analysis provided the most comprehensive overview of the current scope and scale of health literacy in Africa to date. The publications represented 38 of the 54 African Union countries and dated back to 2001, although most were published in the last decade. The content analysis identified 13 broad themes, including mental health, communicable diseases, non-communicable diseases, maternal health, digital health, information and communication, health care, prevention and health promotion, conceptual perspectives, cultural perspectives, outcomes and measurement. The stakeholder analysis revealed a wide range of actors involved in different settings, mostly in health care or community settings. These comprehensive and novel findings can be used to prioritize future actions for public and professional capacity building, policy development and improved practice to improve health literacy for all in Africa.