A scoping review mapping the extent, range, and nature of evidence on whether extreme drought increases hypertension burden, and how this health impact influences financial stability — including gender-differentiated vulnerability — in South Africa, Nigeria, and Ghana. Follows PRISMA-ScR (Tricco et al., 2018). Searches Scopus, PubMed, and Web of Science (148 combined records, July 2026). No existing review has mapped drought, hypertension, and financial stability as a single mediating chain across these three countries; this review identifies that gap and characterizes the available evidence, including country-level differences in data accessibility.