Electrocardiogram (ECG) measurements (intervals, amplitudes, heart rate, and QRS axis) are known to differ with age and sex. Most available data have been collected in Caucasian populations, yet evidence exists for racial differences in ECG findings. Studies of ECG parameters in healthy black African population are few and have their limitations such as those perfomed in hypertensive, HIV/AIDs, ischaemic heart disease and heart failure patients. This study describes changes in major ECG measurements with normal ageing in a population of healthy adult Africans. Similarly, to Caucasians and Asians, significant trends over age and gender have been demonstrated for several variables, which stress the need to interpret ECG findings in view of such parameters. Several findings in this African population differ from those in Caucasian and Asian populations. This suggests that generalization of the currently defined norms for the various ECG criteria (derived from Caucasian populations) may be unsuitable for black African population. The study findings have important clinical implications. This merits the definition and use of age- and sex-specific ECG criteria for the African population.