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Abstract Fish is vital for reducing hunger and malnutrition. However, the combined impact of climate change and overfishing is increasing the hunger and malnutrition burden on the African continent and its population of over 200 million people who depend on marine capture fishing and related activities for survival. Fish farming was introduced to alleviate these problems, and our study assessed the extent to which current fish farming activities in the least developed countries (LDCs) like Sierra Leone provide sufficient micro‐ and macro‐nutrients for local communities. The present study which is based on data from 300 survey questionnaires and 77 semi‐structured interviews administered in three communities in Sierra Leone, and from two expert judgments which investigated the nutritional impact of fish farming activities in Sierra Leone, revealed that (1) there is a range of sub‐standard fish farming activities from sampled farms; (2) that these activities could diminish the nutritional quality of farmed fish; and (3) that coastal communities were suspicious of eating or investing in fish farming. To alleviate Africa's increasing malnutrition, burden, our research highlights the need for investment in nutrition‐sensitive fish farming – a refocus from an emphasis on increasing production and income. The nutritional quality of farmed fish is a more basic consideration than the quantity of production for securing a healthy and economically viable fish farming sector for LDCs like Sierra Leone.