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Unlike many global regions, Sub-Saharan Africa (SSA) has yet to undergo a groundwater revolution. In this paper we confirm that for most SSA countries current groundwater use remains under 5% of national sustainable yield. This is likely to be a constraint on wider economic development and on addressing vulnerabilities to climate change and other shocks. Groundwater use has supported the process of economic structural change in other global regions; hence we derive an empirical model for groundwater use to support economic development, comprising trigger, boom and maturation phases. We identify that the trigger phase depends on political and economic ('secondary') factors, in addition to resource characteristics. The boom phase is described as 'semi anarchic', while the maturation phase is characterized by slowing abstractions but continued economic benefits. In SSA, we posit that the predominance of limiting secondary factors, coupled with a discourse of caution and focus on the maturation phase (more appropriate for other regions), is constraining the use of groundwater for economic development. We suggest that groundwater has the potential to be a foundational resource to support irrigated agriculture, urban and rural water security, and drought resilience across the region, as it has in many other global regions. We argue that overcoming the current barriers and costs to groundwater development can be offset by the benefits of regional socioeconomic development and increased resilience. In the context of enduring poverty and recurrent humanitarian crises in SSA, this new synthesis of information suggests that such an underutilization of sustainable groundwater is unjustifiable. Stakeholders active in the region should prioritize groundwater development to help facilitate a transition to higher value-added activities and greater regional prosperity and resilience, and ensure that measures are put in place for this to be done sustainably. We conclude with some ideas to help trigger such development in SSA. (C) 2019 Elsevier Ltd. All rights reserved.