Charcoal stoves constitute an essential energy provision for millions residing in sub-Saharan Africa; however, conventional designs exhibit inefficiency and pose health risks, contributing to approximately 3.2 million premature fatalities each year due to household air pollution. This systematic review consolidates advancements in charcoal stove technology, with an emphasis on enhancing thermal efficiency, minimizing emissions, and ensuring user safety. Utilizing a methodologically rigorous approach, a total of 52 peer-reviewed studies (1994–2025) were meticulously examined from databases such as Scopus and ScienceDirect, employing standardized testing protocols (e.g., Water Boiling Test). The findings indicate that innovative designs, including rocket and gasifier stoves, attain thermal efficiencies ranging from 17% to 87%, in contrast to the 11% to 16% efficiencies observed in traditional models, alongside reductions in carbon monoxide emissions by as much as 75% and a decrease in fuel consumption by 70%. Nonetheless, performance outcomes exhibit variability in practical applications, influenced by user behavior and the durability of materials employed. The review emphasizes the imperative for validation through field-based studies and the development of economically accessible designs to promote widespread adoption. These technological innovations hold the potential to provide sustainable cooking solutions, thereby contributing to public health and the achievement of environmental objectives such as Sustainable Development Goal 7.