Leptospirosis affects 1 million and kills 60,000 people annually, but it remains poorly documented in Africa. We aim to describe the large West African Conurbation Corridor where the omnipresence of slums, water and close animal/human interactions may result in high leptospiral risk. Though scarce, data from this region point towards the wide circulation of pathogenic leptospires in the urban environment as well as in humans. However, because of the absence of reliable surveillance systems together with lack of awareness, the absence of reference laboratory and/or a high number of infected people showing only mild manifestations, it is likely that the burden is much higher. We believe raising awareness of leptospirosis may have a positive impact on many vulnerable African city dwellers, as the disease is a preventable and treatable.