Africa provides a distinctive context for twin research, with high rates of dizygotic twinning and remarkable population diversity. Yet, the region remains underrepresented in global twin and genetic association studies. Likewise, more data is also needed on overall twin health in the region, particularly in early life when neonatal and infant twin mortality has historically been very high. The African Twins and Multiple Births Research Foundation (ATMBRF), established in 2025 by Malcolm Odion Eremionkhale, addresses this gap through research coordination, advocacy, and infrastructure development. Central to its mission is the African Twin Registry (AfTR), a continent-wide initiative designed to identify and follow twins and higher order multiples via standardized protocols and record linkage methodologies. By integrating registry data with civil and health records, the AfTR will enable comprehensive cohort construction and longitudinal analyses across diverse settings. Its approach aims to combine community engagement, prospective and retrospective recruitment, and anticipated incorporation of genomic data. The AfTR’s data will inform clinical guidelines, health system planning, and culturally grounded interventions addressing multiple births in Africa. This initiative will advance global twin and genetics research by incorporating genetically diverse populations and enhancing the evidence base for precision medicine.