Background Child and adolescent exposure to community and school violence in Africa is pervasive, with significant longer-term consequences for mental health and life outcomes. Aims To synthesise research on the impact of exposure to community and school violence, in terms of mental health and adjustment outcomes. The review focuses on adolescents in countries on the African continent, summarising existing knowledge regarding the impact on mental health and adjustment outcomes of different types of violence, and the associated mediating and/or moderating factors. Method We used the Preferred Reporting Items for Systematic Review and Meta-Analysis protocols (PRISMA-P) to conduct a systematic narrative review (PROSPERO registration CRD42023390724). PsycInfo, MEDLINE, Global Health and Web of Science databases were searched and 36 articles were included in the review. These studies were conducted in countries within Africa among adolescents (10–19 years of age) exposed to violence in their schools and/or communities, and investigated mental health and adjustment outcomes related to violence exposure. Results Adolescents exposed to violence in their schools and communities have increased risk of negative outcomes in areas of psychological, social, behavioural and academic functioning that persist over time. Several mediating and/or moderating variables, such as social support, school climate and negative appraisals, were found. Conclusions Exposure to violence in school and the community has a significant and lasting impact on mental health and adjustment which can be exacerbated and/or ameliorated by several mediating and moderating factors. Future research will benefit from the development and evaluation of interventions that deploy early identification and of secondary prevention interventions which could mitigate effects of exposure to violence for youth in high-risk contexts and emerging economies that face additional economic challenges.