BackgroundAfter many years of legal struggles for the legalisation of recreational use of cannabis, the Constitutional Court of South Africa ruled in favour of the applicants in September 2018. Although the ruling issued caution regarding the social challenges accompanying this legalisation, it did not address how the country would deal with the societal consequences of this ruling.AimThe aim of this article was to discuss the social and public health implications of the legalisation of recreational cannabis on South Africa.MethodsLiterature review on the social, health and legal impacts of legalisation of cannabis, considering experiences of other countries that have legalised cannabis.ResultsThe legalisation brings a range of significant negative consequences, which include an expected increase in the number of users and the subsequent undesirable effects on the physical, mental and social health of communities.ConclusionIn terms of financial, infrastructural and human resources, South Africa cannot afford the consequences of the legalisation of recreational cannabis. Poor communities, children and the youth will carry the brunt of the scourge of cannabis use.