Sub-Saharan Africa has experienced an impressive 5% annual economic growth since the late 1990s, outpacing the world average. But other aspects of the region’s development are lagging. The region is behind on many of the Millennium Development Goals (MDGs), a set of goals agreed upon by world leaders at a UN summit in 2000 to reduce poverty, improve health, and foster economic development. Sub-Saharan Africa is especially deficient in areas of reproductive health crucial for meeting MDGs for child and maternal health. This brief examines successes and failures in reproductive health in sub-Saharan Africa, focusing on variations in family planning use and family size, maternal mortality, and HIV/AIDS in major sub-Saharan regions.