Africa is a diverse continent composed of many different terrestrial biomes, from the largest nonpolar desert in the world to equatorial forests and Southern African Fynbos. Biodiversity within the continent is high but much remains to be discovered. Sightings of hypogeous fruiting bodies of mycorrhizal fungi (truffles and truffle-like fungi) have been recorded from the most northern countries of the continent to the most southern countries; they have been widely collected for culinary and medicinal purposes. In this review, we describe the most prominent species of mycorrhizal fungi forming hypogeal fruiting bodies, across six genera. The most ubiquitous of these are the “desert truffle” species and the most common genus of plants with which they associate are those of the genus <em>Helianthemum</em>. We also describe the key species of truffle and truffle-like fungi in continental Africa. Where information exists, we describe the ecology, medicinal properties, and ethnomycology of the identified fungi.