Competency to stand trial is an important legal safeguard for persons accused of a crime.Defendants have the right to fully participate in any criminal proceedings that involve them. However, for this right to be realized and to ensure procedural fairness, the legal system must ensure that persons accused of crime are of "sound mind" to stand trial. The very nature of the adversarial system of trial requires that defendants are in a position to assist their attorneys by providing them with relevant information about the case and locating witnesses. When issues of incompetency are suspected, or raised, before or during the trial, the court has a duty to request for evaluation from forensic mental health professionals. The outcome of the evaluation is intended to assist the court to decide whether to proceed with a trial or not. Although competency to stand trial is to ensure due process rights and judicial integrity, it has received little scholarly attention across Africa. This chapter will examine competency to stand trial in jurisdictions across Africa. The chapter will first review the history and definition of competency as used in the legal system. Next, we provide an overview of legislations across Africa and selected high income countries. The third section will discuss the evaluation of competency to stand trial, with a focus on the administration of competency evaluation instruments and collateral sources of data. The last section will focus on the disposition of incompetency and competency restoration of incompetent defendants. We conclude with recommendations for future research on competency to stand trial in Africa.