Cerebral coenurosis is a fatal parasitic neurological disease affecting the brain and spinal cord of goats and sheep. Despite the large population of sheep and goats in Africa, there is very little awareness about the scale or effects of the disease. A systematic review was conducted to bridge the gap in the current understanding of the epidemiology of Taenia multiceps coenurosis in Africa. A detailed literature search was conducted in EBSCOhost, Google Scholar, Research4life (AGORA), and PubMed for studies in T. multiceps coenurosis in goats and sheep in Africa for the period spanning January 2000 to December 2019. The search identified 574 publications, of which only 11 studies were eligible, highlighting major gaps in reporting of this disease in Africa. Data were extracted and evidence synthesized in relation to prevalence and determinants for T. multiceps coenurosis. The descriptive summary statistics revealed a median (IQR) prevalence of coenurosis of 22.3% (range: 18.3–26.4 percent) for community based and 14.8% (range: 3.8–45.6) for abattoir-based studies. This high prevalence indicates that Taenia multiceps coenurosis is an important disease for small ruminant productivity in Africa. Knowledge of the determinants of prevalence could be used to inform preventive measures, including behaviour change among livestock keepers and those involved in livestock slaughter to break cycles of transmission between small ruminants and dogs.