A systematic review and meta-analysis of 35 studies conducted in 11 African countries found that 63.31% of university students in Africa have poor sleep quality, with high heterogeneity (I² = 97.2). Subgroup analysis showed varying prevalence rates across regions, with the highest in South Africa (69.59%) and the lowest in Morocco (46.81%). Factors significantly associated with poor sleep quality included being stressed (AOR=2.39), being in the second academic year (AOR=3.10), using electronic devices at bedtime (AOR=3.97), and having a comorbid chronic illness (AOR=2.71). The study highlights the high prevalence of poor sleep quality among African university students and its association with stress, academic year, electronic device use, and chronic illness. Addressing these factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. The study was registered in PROSPERO (CRD42023493140) and is available in open access. Keywords: sleep quality, university students, systematic review, meta-analysis, Africa.A systematic review and meta-analysis of 35 studies conducted in 11 African countries found that 63.31% of university students in Africa have poor sleep quality, with high heterogeneity (I² = 97.2). Subgroup analysis showed varying prevalence rates across regions, with the highest in South Africa (69.59%) and the lowest in Morocco (46.81%). Factors significantly associated with poor sleep quality included being stressed (AOR=2.39), being in the second academic year (AOR=3.10), using electronic devices at bedtime (AOR=3.97), and having a comorbid chronic illness (AOR=2.71). The study highlights the high prevalence of poor sleep quality among African university students and its association with stress, academic year, electronic device use, and chronic illness. Addressing these factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. The study was registered in PROSPERO (CRD42023493140) and is available in open access. Keywords: sleep quality, university students, systematic review, meta-analysis, Africa.