Necessity entrepreneurship, which is self-employment driven by the absence of better livelihood options, is the most prominent form of entrepreneurship in Sub-Saharan Africa (SSA). However, the scientific literature remains scattered and theoretically underdeveloped. This article presents a systematic review of necessity entrepreneurship in SSA, synthesising 27 empirical studies published between 2010 and 2026 following PRISMA 2020 guidelines and thematic synthesis. Three research questions guide the review: (RQ1) how necessity entrepreneurship is conceptualised and measured in SSA; (RQ2) what factors drive it; and (RQ3) what consequences it produces. Seven analytical themes emerge: (1) a conceptual shift from a binary to a heterogeneous, contextually anchored understanding of necessity entrepreneurship; (2) structural and institutional drivers, including unemployment, poverty, and institutional voids; (3) social exclusion pathways such as migration, discrimination, widowhood, and crisis-induced displacement; (4) gendered constraints to entrepreneurship; (5) monetary constraints and the enabling role of financial infrastructure, with particular attention to digital financial services; (6) the necessity-to-opportunity transition pathway; and (7) nonmonetary consequences including identity formation and community effects. The review demonstrates that the binary GEM approach is inadequate for the SSA context, that gender operates as a pervasive structural moderator, and that informal and digital financial institutions play an increasingly central role in shaping necessity entrepreneurship across the region.