The most recognizable pathological condition of the human oral cavity is, arguably, dental caries. Beyond a direct impact on oral health, caries presence (or absence) provides important data for bioarchaeologists—to help reconstruct the diet of past populations and individuals. This study explores such data in 44 samples (n=1,963 individuals, 62,816 teeth) dating between 10,000 BP and recent times across the African sub-continent. It is, to date, the most extensive investigation of its kind in this part of the world, entailing descriptions and quantitative comparisons of caries by period, environment, subsistence strategy and sex. Mann-Whitney U tests and factoral ANOVA results provide expected and some unexpected findings, including: 1) a diachronic increase in caries prevalence across the sub-continent, likely related to diet change from widespread population movement; 2) savanna peoples exhibit more caries than those from other environmental regions; 3) subsistence strategy plays a major role in caries occurrence; and 4) males and females do not evidence significant differences in caries frequencies, but variation does exist in several regional groups. These findings reveal that global trends described by previous researchers often apply, though not always—so it is prudent to consider regions independently.