Africa is known for its rich, ancient tradition in fermented foods. Among these, fermented dairy products represent one category that is widely consumed, contributing to the socio-economic development and food security of the people. In Africa, traditional food fermentation lends itself as a relatively cheap food processing technology that often improves shelf life/food safety as well as nutrition and health via improvement in the levels of specific micronutrients and the action of probiotics. A range of African fermented dairy products (mainly yoghurt-like products) are produced by spontaneous fermentation, and these fermented dairy products harbor rich and valuable microbial diversity, predominated by lactic acid bacteria and yeasts. Detailed knowledge of the production processes, microbiological and biochemical aspects of traditional African dairy fermentation is critical for the development of products with enhanced quality, safety and health benefits for a sustainable food security in the region. This review therefore provides a comprehensive overview of the traditional African fermented dairy processing technology, as well as technologically relevant microorganisms and health benefits associated with fermented dairy products. Efforts aimed at harnessing the functional food potential of these fermented products could help control some food and health challenges facing many countries in the region.