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The utilization of traditional medicine (TM) is prevalent among the general population in Africa; however, its use among individuals with diabetes in the region remains underdocumented. This review aimed to synthesize the available literature to identify the prevalence and predictors of TM use among persons with diabetes in Africa. A systematic search was conducted across multiple databases, including MEDLINE, Embase, CINAHL, and AMED, covering studies published from 2000 to April 2023. Of 1560 records identified, 24 articles met the inclusion criteria. The prevalence of TM use varied significantly, ranging from 12.4% to 77.1%, with a median prevalence of 50%. TM was commonly used concurrently with conventional medicine (CM) (35.4–88.4%), with a majority (63.8–91.3%) not disclosing TM use to healthcare providers. Female gender, long diabetes duration, use of oral antiglycaemic medication …