Herbal preparations have long been accepted in Africa as alternative or complementary medicine. However, the herbal preparations have been found to contain undeclared synthetic drugs known as adulterants. This review was intended to find out the incidence of adulteration of herbal preparations in Africa and its impacts on the regional health. A search strategy through multiple databases was conducted across PubMed, Google, Google Scholar, Science Direct, Cochrane databases, Scopus, and Google Scholar using appropriate search terms such as herbal medicines, herbal preparation, impacts of herbal medicines in Africa, health implications of herbal medicines in Africa. About 112 articles published from 1995 to 2026 were accessed and eligible articles data were extracted and analyzed. Adulteration of herbal preparation used in Africa has become healthcare setback instrument in hands of greedy manufacturers of these remedies. It was observed that this menace affect every part of African healthcare delivery system. The most commonly adulterated herbal preparations in Africa are those used for weight loss and weight gain, aphrodisiacs, anti-inflammatory, antidiabetics, antimicrobials, and antihypertensives. Glibenclamide and Metformin were the commonest adulterants in the antidiabetic herbal preparations. Trimethoprim, chloramphenicol, amoxicillin and ciprofloxacillin were the commonest adulterants in herbal antibacterial preparations. Chloroquine was the commonest used adulterants in the herbal antimalarial preparations. The risks of the adulterations include meningitis, lead poisoning, nephrotoxicity, renal or liver failure, coma, and death. Establishment of stringent quality control and its enforcement should be employed in each African country in order to curb the menace.