Background: Sub-Saharan Africa has the highest average fertility rate in the world. In 2009, the average number of births per woman was 5.1—more than twice as many as in South Asia (2.8) or Latin America and the Caribbean (2.2). More than 100 million women in less developed countries, or about 17 percent of all married women, would prefer to avoid a pregnancy but are not using any form of family planning. Currently, approximately 24.8 percent of African women have unmet needs for family planning; this simply means 24.8 million women of reproductive age who prefer to avoid or postpone childbearing are not using any method of contraception. Objective: To make a review of trends of family planning practice in Sub Saharan Africa from 1980 to 2010 among women of reproductive age. Methodology: Meta-analysis of detailed literature by authors of articles published since 1980 from various sources, including Demographic Health Survey (DHS) of 1990 to 1995, 2000 to 2005, and of 2005-2010 from Sub-Saharan Africa such as South Africa Demographic Health Survey (SADHS) and Tanzania (TDHS); and observation on the relationship between family planning use and fertility in Africa. Findings: An analysis of fertility trends in 23 countries of Sub-Saharan Africa from 1980 to 1995 showed that in two-thirds of the countries there was evidence of fertility decline, with a particularly rapid decline in Kenya and Zimbabwe. Furthermore 2010 statistics show the African total fertility rate to be standing at 4.7. These rates reflect contraceptive prevalence of these specific regions.Generally in all world regions, contraceptive use corresponds with fertility patterns. In regions where contraceptive use is widespread, fertility is low but in regions where contraceptive use is uncommon, fertility is high. Conclusion: The paper has shown that the high fertility pattern in Africa is among others, a result of the ineffectiveness of family planning programs. Recommendation: The overall low rate of contraceptive prevalence and high unmet need for family planning suggests the need for African national governments and population policy makers to rethink access to contraceptives.