To examine the major determinants of VCT service uptake among adults in SSA. Electronic databases were searched to identify eligible English language publications. Reporting of the study selection procedure was done according to PRISMA and the selected articles were also critically appraised. We found 8 significant determinants of VCT uptake among adults in SSA, such as less physical access [OR (Odds ratio): 0.77 (95% CI (Confidence interval): 0.62-0.96), < 0.01], older age [OR: 1.36 (95% CI: 1.08-1.73), < 0.01], higher education level [OR: 1.60 (95% CI: 1.24-2.05), < 0.01], high knowledge of HIV and VCT awareness [OR: 1.40 (95% CI: 1.03-1.90), < 0.01], unprotected sexual practices [OR: 1.75 (95% CI: 1.18-2.58), < 0.01], discussion on HIV among partners and others [OR: 1.76 (95% CI: 1.10-2.81), < 0.01], other STIs [OR: 1.40 (95% CI: 1.00-1.98), < 0.01], and divorced/separated [OR: 1.39 (95% CI: 1.12-1.72), < 0.01]. This study showed that 8 determinants were significantly associated with VCT service uptake in SSA. Thus, HIV interventions and policy initiatives should be tailored to these determinants to ensure scale-up of VCT service uptake in SSA.