Rickettsia africae is a bacterium of zoonotic importance, which causes African tick bite fever (ATBF) in humans. This pathogen is transmitted by ticks of the genus Amblyomma, with Amblyomma hebraeum and Amblyomma variegatum being the major vectors. Tick species other than the above-mentioned have also been reported to carry R. africae DNA. There is scarcity of information on the epidemiology of this pathogen, yet several cases have been recorded in foreign travellers who visited endemic areas, especially southern Africa. The disease has rarely been described in people from endemic regions. The aim of this study was to discuss the information that is currently available on the epidemiology of R. africae, highlighting the gaps in this field. Furthermore, ATBF cases, clinical signs and the locations where the cases occurred are also listed in this review.