Objectives  In Sub-Saharan Africa, acquired immunodeficiency syndrome (AIDS) orphans account for a large proportion; however, their mental health problems have been overlooked. We presented an investigation of literature to provide a comprehensive overview of associated factors of mental health among AIDS orphans in Sub-Saharan Africa. Methods  Databases (PubMed and Japan Medical Abstracts Society) were searched by using relevant keywords including AIDS orphans, Sub-Saharan Africa, mental health, psychological support, education, and poverty. A total of nine papers met the inclusion criteria and were included in this literature review.Results  AIDS orphans were at high risk of various mental disorders relevant to low self-esteem, anxiety, and depression. Associated factors of the mental health of AIDS orphans were classified into the following three categories: psycho-social-cultural factors such as social discrimination, abuse, and bullying etc.; physical environmental and economic factors such as education, lack of foster care, and poverty etc; and family and community relevant factors such as lack of connection and social support from family and school etc. Regarding psycho-social-cultural factors, AIDS orphans experienced more abuse, social discrimination, and social stigma, especially those who were living in poverty. AIDS orphans living in the urban experienced severe bullying. Regarding family and community factors, due to the loss of parents and changes in living environment, AIDS orphans who were living in households headed by children tend to experience depression, anxiety, fear, and stigma. The loss of a parent resulted in lower academic performance and limited access resources including inadequate mental health services, which consequently led to poor development and adverse health outcomes in AIDS orphans including poor psychosocial well-being. Regarding environmental and economic factors. Lack of care from caregivers and parental mental health were also shown to be related to child development and mental health in AIDS orphans. Regarding physical environmental and economic factors, limited available social support in the physical environment where AIDS orphans lived was associated with impaired development and mental health. Poverty led to AIDS orphans being affected by food shortage and malnutrition (e.g., stunting), child labor, as well as risky sexual behaviors towards female AIDS orphans. Better social support from caregivers and teachers had a positive impact on the mental health of AIDS orphans. With regard to education, AIDS orphans have a high school dropout rate, resulting in fewer school connections. School connections have been shown to be an important protective factor for AIDS orphans’ mental health. Conclusions  This review identified risk and protective factors of mental health among AIDS orphans in sub-Saharan Africa. Our results, especially the positive influence of social support, encourage the development of effective mental health care programs for AIDS orphans in sub-Saharan Africa. The results suggest looking at various problems that AIDS orphans are facing from multiple perspectives.