The article explores the indigenous Ndau people’s conceptualisation of ungomwa (infertility) and its management. More specifically, I investigated the Ndau beliefs and practices around ungomwa. I conducted a literature review, informal conversations and made observations for data collection. I delimited the study to causes of infertility among Ndau males, its detection, effects, and how it is managed within Ndau cosmology. The findings showed that, although beliefs on ungomwa were varied, it is an undesirable condition. It results in childlessness, which presents serious problems; victims suffer personal grief and frustration, social stigma, and ostracism. Using an indigenous knowledge perspective in a patriarchal Ndau community, I argue that men want to maintain their ego and masculine grandstanding in the community and usually blame women for the infertility. More important to note is that there are indigenous knowledge systems that can be employed to (mis)manage infertility if detected early at youth. If detected when a man is already in marriage, measures are put in place to ensure children are born in the family. I argue that ungomwa is a gendered, cultural, and psycho-social sexual reproductive health challenge that can be innovatively managed for human flourishing.