Africa is one of the regions with high mycotoxin contamination of foods and continues to record high incidences of liver cancers globally. The agricultural sector of most African countries depends largely on climate variables for crop production. Production of mycotoxins is climate-sensitive. Most stakeholders in the food production chain in Africa are not aware of the health and economic effects of consuming contaminated foods. The aim of this review is to evaluate the main factors and their degree of contribution to the high levels of mycotoxins in African foods. Thus, knowledge of the contributions of different factors responsible for high levels of these toxins will be a good starting point for the effective mitigation of mycotoxins in Africa. Google Scholar was used to conduct a systemic search. Six factors were found to be linked to high levels of mycotoxins in African foods, in varying degrees. Climate change remains the main driving factor in the production of mycotoxins. The other factors are partly man-made and can be manipulated to become a more profitable or less climate-sensitive response. Awareness of the existence of these mycotoxins and their economic as well as health consequences remains paramount. The degree of management of these factors regarding mycotoxins varies from one region of the world to another.