The Late Pleistocene Middle Stone Age (MSA) record of Africa provides early examples of standardised stone tool production and complex manufacturing sequences, superficially implying a long-term trend towards greater complexity in MSA technology at a continental scale. However, at this scale, spatial and temporal expressions of technological complexity are uneven. New lithic and chronometric data from the East-Central African record add further regional perspective to these patterns. Stone artefact assemblages from Karonga, northern, Malawi (92-22 ka), persistently lack the complexity demonstrated elsewhere in Africa at the same times, despite similar lithic raw materials. These new data provide an essential avenue for exploring hypotheses about the roles of environmental risk and demography in shaping the expression of MSA technology across the continent, not just at a local scale. When set within this framework, the simplicity of the Karonga MSA is best explained by its position in an environment that was persistently low in relative extrinsic subsistence risk. These results reinforce that motivations to invest in complex tools were variable through space and time, and that this variation, more than factors relating to behavioural capacity, may explain the patchy evidence for lithic complexity in the later MSA.