Sanitation, including the proper management of wastewater, is central to ensuring human and ecosystem health, and economic and environmental benefits. While significant efforts are being made across Africa to ensure better access and services, many places still have inadequate infrastructure for sanitation and wastewater management. This atlas profiles the state and trends in wastewater management and sanitation delivery in Africa; highlights the human health and ecosystem impacts of poor sanitation and wastewater management; and discusses the continent’s policy and institutional arrangements. It benchmarks Africa’s progress towards the Sustainable Development Goals (SDGs) and other aspirations, including Africa’s Agenda 2063 and Africa’s Water Vision 2025. The findings of the atlas will allow policymakers to track progress on sanitation and wastewater, making it a valuable tool to accelerate change.