Reproductive justice (RJ) moves beyond reproductive rights and incorporates the economic, political, social, spiritual, cultural and health factors that impact on women’s reproductive choices and decision-making ability. In spite of the juridical recognition of reproductive rights, RJ, as the paper illustrates, remains elusive for millions of women in sub-Saharan Africa (SSA) generally and Eastern and Southern Africa (ESA) in particular. There are many challenges, in the context of RJ, including, maternal morbidity and mortality; teen pregnancies and child marriages; limited intake of family planning services; unsafe abortion; infertility; and reproductive cancers.