This paper presents an overview of current household energy trends in Africa, and the reasons why access to modern cooking facilities remains so low. It then presents the latest evidence on the health, environmental and socio-economic impacts of traditional biomass use in sub-Saharan Africa, with a dedicated section on the particular challenges associated with charcoal as a household cooking fuel. Next, it highlights where interventions to provide access to clean and improved cooking options are having a positive impact, drawing on case studies in Mali, Ghana, Kenya and Ethiopia.