Achieving food and nutrition security remains a significant challenge for small-scale farmers in Sub-Saharan Africa (SSA). However, indigenous vegetables offer a promising solution to this challenge. This systematic review used four databases and retrieved 38 studies published over the past 20 years for synthesis. These studies highlight the growing importance of indigenous vegetables grown in home gardens as a sustainable solution to improve livelihoods and dietary diversity. Indigenous vegetables are well-suited to local conditions, nutritionally rich, and were associated with improved household food availability and income. However, farmers face various risks, including environmental, technological, economic, institutional, and social risks, which threaten their production. To overcome risks, farmers adopt strategies such as training, cooperatives, improved storage, and better seed varieties. Indigenous vegetable cultivation also empowers women and marginalised groups who play key roles in home gardening. Despite their benefits, indigenous vegetables remain overlooked in mainstream markets and policies. The review recommends that policymakers and stakeholders must provide support to promote indigenous vegetables through training and market integration, helping farmers commercialise their produce, while simultaneously enhancing food and nutrition security. Further research is needed to explore the profitability of indigenous vegetable production, analyse supply value chains, and investigate processing and manufacturing opportunities to support their market potential and sustainability.