A form of tattooing called cicatrisation or scarification is widely practiced in traditional African societies. Rubbing charcoal into small cuts made with razors or thorns forms decorative patterns of scar tissue in the skin. These designs are often indicative of social rank, traits of character, political status and religious authority. For African women, scarification is largely associated with fertility. Scars added at puberty, after the birth of the first child, or following the end of breastfeeding highlight the bravery of women in enduring the pain of childbirth. Scars on the hips and buttocks, on the other hand, both visually and tactually accentuate the erotic and sensual aspects of these parts of the female body.

Some early African fertility carvings had symbols on them that may be tattoos.

See the Lars Krutak article Dinembo: Tribal Tattoos of the Makonde for more information about tattoos and tattooing in Africa.