Available empirical evidence suggests that many primate populations are increasingly threatened by anthropogenic actions and we present evidence to indicate that Africa is a continent of particular concern in terms of global primate conservation. We review the causes and consequences of decline in primate diversity in Africa and argue that the major causes of decline fall into four interrelated categories: deforestation, bushmeat harvest, disease and climate change. We go on to evaluate the rarity and distribution of species to identify those species that may be particularly vulnerable to threats and examine whether these species share any characteristic traits. Two factors are identified that suggest that our current evaluation of extinction risk may be overly optimistic; evidence suggests that the value of existing forest fragments may have been credited with greater conservation value in supporting primate populations than they actually have and it is clear that the extinction debt from historical deforestation has not being adequately considered. We use this evaluation to suggest what future actions will be advantageous to advance primate conservation in Africa and evaluate some very positive conservation gains that are currently occurring.