We analyzed the mortality impacts and greenhouse gas (GHG) emissions produced by household energy use in Africa. Under a business-as-usual (BAU) scenario, household indoor air pollution will cause an estimated 9.8 million premature deaths by the year 2030. Gradual and rapid transitions to charcoal would delay 1.0 million and 2.8 million deaths, respectively; similar transitions to petroleum fuels would delay 1.3 million and 3.7 million deaths. Cumulative BAU GHG emissions will be 6.7 billion tons of carbon by 2050, which is 5.6% of Africa's total emissions. Large shifts to the use of fossil fuels would reduce GHG emissions by 1 to 10%. Charcoal-intensive future scenarios using current practices increase emissions by 140 to 190%; the increase can be reduced to 5 to 36% using currently available technologies for sustainable production or potentially reduced even more with investment in technological innovation.