Breast ironing, a clandestine practice prevalent in several African countries, represents a covert form of gender-based violence (GBV) with profound implications for the physical, psychological, and social well-being of girls. The practice involves pressing or massaging a girl’s developing breasts with heated objects like grinding stones and pestles to arrest breast development, thereby making the girl less attractive to men; and reducing the chances of her having sexual intercourse. This review article examines the phenomenon of breast ironing within the broader context of GBV in Africa, exploring its prevalence, sociocultural roots, health consequences and societal implications, prevention challenges and strategies for intervention. A key aspect emphasized is the need to recognize and address the potential medicalization of breast ironing, similar to efforts seen in combating female genital mutilation (FGM). Preventive strategies must include maintaining a high index of suspicion for medicalization, ensuring that healthcare providers are educated about the dangers of this practice and empowered to intervene effectively. Addressing breast ironing requires a multifaceted approach that acknowledges its sociocultural complexities, prioritizes preventive measures and leverages the power of research. By integrating these elements into comprehensive prevention strategies, we can work towards ending the harmful practice of breast ironing and safeguarding the health and well-being of African girls. Political will and action are paramount in preventing breast ironing in Africa. Leaders must prioritize legislation, allocate resources, and collaborate with stakeholders to eradicate this harmful practice and protect vulnerable individuals.