This chapter highlights a high rate of water crisis across sub-Saharan Africa (SSA) despite its huge hydro. For example, currently, less than 2% of SSA\'s renewable groundwater is used to irrigate just about 1% of its cultivable land. Factors contributing to water stress include rainfall deficit and drought, increased water requirements, population growth, urbanization poverty. Coupled with the uneven distribution of water resources and mismanagement of water facilities, the gap between the demand for water and available supply in SSA has deepened. This has led almost half of the SSA population to drink water from unprotected sources. Moreover, many millions travel far distances and spend several hours daily to collect water. Children and women are mainly involved in water collection. The growing scarcity of water in Africa has a negative impact on economic growth. Besides, water shortages are at the heart of many social crises, and have become directly or indirectly the first cause of death in Africa linked to waterborne diseases. The prevailing water-related diseases include malaria, typhoid fever, cholera, poliomyelitis, etc. To attain the African agenda 2063, national governments in SSA need a multidisciplinary approach integrating supervising informal settlements of the population in urban and peri-urban areas; improving water storage capacity; and increasing irrigation potential for agriculture and having a good understanding of the epidemiology of waterborne diseases.