There are few changes in the history of human existence comparable to urbanization in scope and potential to bring about biologic change. The transition in the developed world from an agricultural to an industrial-urban society has already produced substantial changes in human health, morphology and growth (Schell, Smith and Bilsborough, 1993, p.1). By the year 2000, about 50% of the world s total population will be living crowded in urban areas and soon thereafter, by the year 2025 as the global urban population reaches the 5 billion mark more of the world s population will be living in urban areas. This has enormous health consequences. By the close of the twenty-first century, more people will be packed into the urban areas of the developing world than are alive on the planet today (UNCHS (Habitat), 1996, p.xxi). Africa presents a particularly poignant example of the problems involved, as it has the fastest population and urban growth in the world as well as the lowest economic development and growth and many of the poorest countries, especially in Tropical Africa. Thus it exemplifies in stark reality many of the worst difficulties of urban health and ecology (Clarke, 1993, p.260). This essay is therefore concerned to analyse the trends of urbanization in Africa. This is followed by an overview of the environmental conditions of Africa s towns and cities. The subsequent section explores the links between the urban environment and health. Although the focus is with physical hazards it is important to note that the social milieu is also vital in the reproduction of health. The paper concludes by providing some policy recommendations