BackgroundRisk identification, as well as the prevention and management of diseases associated with pregnancy or other conditions that may occur concurrently, is the essential component of ANC.MethodThe observational follow-up and cross-sectional studies on the effect of antenatal care on low birth weight in Africa were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Five computerized bibliographic databases: Google Scholar, PubMed, Scopus, Cochrane Library, and Hinari Direct were searched for published studies written in English till May 2022. The risk of bias assessment tools developed by the Joanna Briggs Institute for cross-sectional and observational follow-up research was used, and the caliber of each included study was assessed. Seven papers were included, with a total of 66,690 children participating in the study.ResultsSeven studies met the selection criteria. Prenatal care and low birth weight were linked in four of the seven studies included in the review. The pooled odd ratio for low birth weight in the random-effects model was 0.46 (95% CI: 0.39, 0.53). The pooled odds ratio for low birth weight was 0.21 (95% CI: 0.19, 0.22) and 0.21 (95% CI: 0.19, 0.22), respectively, among pregnant women who had no antenatal care follow-up and those who had antenatal care follow up.ConclusionWomen who attended at least one antenatal care appointment were more likely than their counterparts to have a baby of normal weight. Interventions to reduce low birth weight in Africa should focus on providing adequate antenatal care and quality healthcare services to women with low socioeconomic status.