Group B streptococcal infections are a leading cause of neonatal morbidity and mortality. Maternal microbiological screening during pregnancy and intrapartum antimicrobial treatment of maternal group B streptococcus (GBS) colonization constitutes an effective prevention strategy to reduce early neonatal invasive disease due to GBS in the European and North American setting. Data on the prevalence of GBS colonization in pregnancy and incidence of neonatal invasive GBS disease are very limited for low-income regions. However, the first reports from sub-Saharan Africa indicate that GBS colonization rates may be comparable to industrialized countries and that related neonatal morbidity and mortality is of significance. Prior to the development of suitable prevention strategies, which are undoubtedly needed in resource poor settings, more evidence on GBS epidemiology in sub-Saharan Africa and assessment of cost effectiveness of different prevention strategies are essential.