Meaningful proportions of households on the South African Highveld regularly use energy carriers that result in the emission of significant quantities of particulate and gaseous pollutants. Dirty fuels are mostly used by lower-income households, with the exception of recreational wood use that is also prevalent in higher-income households. The dirty fuel use patterns and trends observed on the Highveld are the result of the unique combination of the utility, accessibility, affordability, availability, and desirability of the energy carriers and equipment, climatological factors, markets and infrastructure, as well as the inertia of historic energy use patterns. There are no systematic reviews and prognosis of the use of dirty fuels by low-income households on the South African Highveld that consider critical recent events such as the Covid pandemic and emerging dynamics such as the just transition movement. In this article we will use a literature review as well as our own research to describe dirty fuel use by low-income households on the Highveld, paying specific attention to changes over time. We will attempt to describe what is being used, who the users are, and for which utilities fuels are being used. From these descriptions, specific patterns emerge that shed light on possible avenues and prospects for ending dirty fuel use on the Highveld.