Workforce shortages, limited diagnostic infrastructure, and inconsistent access to essential medications contribute to significant gaps in neurology care across African countries.

Ninety respondents from 19 African countries participated, with the largest representation from Nigeria, Tanzania, and Zambia. Most worked in public institutions (87.8%), though only one-third had dedicated neurology departments. Neurologists and neurosurgeons were available at most sites but often in limited numbers. Nearly two-thirds (62.5%) had dedicated inpatient neurology wards, while outpatient clinics were more common (84.1%), with stroke, epilepsy, and migraine most frequently reported. Majority of survey participants noted wait times to see a neurologist of less than one month for initial visits and 1–3 months for follow-up. A majority of institutions were affiliated with medical schools (80.7%), with neurology and neurosurgery residency programs present in over 70% of sites, though training capacity varied. Telehealth availability was low (23.5%), with major barriers including lack of software and limited partnerships. Access to basic diagnostics (i.e. CT, EEG, lumbar puncture) and essential therapies (i.e. antihypertensives, antiplatelets, anticonvulsants) was widespread, while advanced diagnostics (i.e. PET, evoked potentials, transcranial Doppler) and therapies (i.e. thrombolysis, thrombectomy, plasma exchange) were largely unavailable.