| Sumario: | Background: Pre-eclampsia is a hypertensive disorder of pregnancy and a major cause of maternal and neonatal mortality worldwide, with a disproportionately high burden in sub-Saharan Africa. Objective: This review synthesised evidence on how men engage with pre-eclampsia in the region. Design: This systematic review included qualitative designs and cross-sectional studies. Data sources and methods: Search was done across five primary databases (PubMed, Scopus, Embase, CINAHL and Web of Science). Additional searches were carried out in online sources like institutional repositories, HINARI, Dimensions AI and Google Scholar for studies published between 2000 and 2025. This review followed PRISMA guidelines and the Joanna Briggs Institute (JBI) framework. Data were appraised using JBI tools and synthesised thematically. Results: Twelve studies from Tanzania, Uganda, Ghana, Nigeria and Mozambique were included. Knowledge of pre-eclampsia varied widely; that is, only 24.8% of men demonstrated high awareness, while misconceptions, such as attributing the condition to stress, cold or supernatural forces, were common. Men's roles spanned financial provision, decision-making, emotional and household support and information sharing, but overall involvement was moderate. Perceptions were shaped by cultural, social and spiritual narratives, while health system barriers such as unclear roles and exclusionary practices reduced engagement. Conclusion: Male partners' knowledge, perceptions and roles significantly affect maternal outcomes in sub-Saharan Africa. Findings show the need for targeted education, culturally sensitive interventions and health system reforms that encourage male participation. Strengthening men's engagement could reduce delays in care-seeking, improve antenatal care utilisation and contribute to lowering maternal and neonatal mortality. Trial registration: Open Science Framework with the DOI: https://doi.org/10.17605/OSF.IO/WHB93. Plain language summary: Men's role in pre-eclampsia care: understanding and support in sub-Saharan Africa This review looked at how men in sub-Saharan Africa understand and support women with pre-eclampsia, a dangerous pregnancy condition that can lead to death if not treated. Based on studies from five countries, many men had limited or incorrect knowledge about the condition, often linking it to stress or supernatural causes. While men did provide support like money, help at home, or making health decisions, their involvement was often unclear or limited due to cultural beliefs and health systems that left them out. Educating men and including them more in pregnancy care could help save the lives of mothers and babies.
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