Backgrond: Despite global legislative and regulatory efforts to ensure sustainable food safety and security, mycotoxins remain a serious challenge in the supply of staple food commodities like maize and other grains in South Africa. Objectives: We reviewed mycotoxin contamination of maize, maize-associated food products, together with other cereals to emphasis the need for continuous monitoring and management in South Africa. Methods: A scoping review was conducted on mycotoxin contamination of maize, maize-related products, and other cereals, as well as associated health implications in South Africa. The review intended to identify relevant articles and reports from 1980 to 2020 based on Arksey and O’Malley guidelines. Results: Of the 103 articles/reports identified for the research questions “that define to what extend the South African population is exposed to mycotoxins, and why”, 31 (30 %) were eligible for this study. The most recurrent mycotoxins were fumonisins (FBs) and aflatoxins (AFs). The levels of FBs and AFs were as high as 140480 and 762 µg/kg, respectively. Conclusion: The FBs and AFs were the main mycotoxins in maize, other cereals, and related products. Therefore, adopting effective, sustainable, and scalable measures in limiting mycotoxin contamination is critical for the mitigation of food insecurity and the resulted health burden. Training farmers and other stakeholders on good hygiene and farming practices along the food chain is important.