Exercise caution — there are real risks that travellers should plan around. Public infrastructure and health services are limited outside the main cities.
Regional breakdown
Most visitors land at Sao Tome International Airport and base themselves in the capital, Sao Tome city, on the larger island. The city is small and walkable. Street crime is generally low by regional standards. But bag snatching and opportunistic theft do happen around the Mercado Municipal and on quiet beaches after dark. Watch out for poor street lighting and uneven pavements once the sun drops. Outside the capital, travellers tend to head south through Trindade and Bombaim into the Obo Natural Park. Or down the west coast to Neves and the old roca plantations. Roads narrow quickly and can wash out in the rainy season from October to May. Mobile signal drops in the forest interior. If you hike Pico de Sao Tome or visit Lagoa Azul, go with a local guide and tell someone your plan. The smaller island of Principe, reached by a short flight from Sao Tome, is quieter again. Santo Antonio is the only town of any size. Medical facilities on Principe are very basic, so anything serious means a flight back to the main island or onward evacuation. Boat transfers between the islands are weather dependent and sometimes cancelled at short notice.
Recent advisory changes
The official advisory guidance last updated its Sao Tome and Principe page on 10 December 2025. It does not warn against travel to any part of the country. The update focused on entry requirements for dual nationals returning to the UK rather than any new safety concern. The official advisory guidance reissued its advisory on 8 October 2025 at Level 2, Exercise Increased Caution. The reason is health, not crime or political risk. The notice flags that medical services across both islands are limited, there are no proper trauma or ambulance services. And even small health problems may need medical evacuation at the traveller's own cost. The US Embassy in Luanda, Angola covers consular matters for Sao Tome and Principe, which means in-country US support is minimal.
What travellers should know
Medical cover is the single biggest practical issue. Take out travel insurance that clearly includes emergency medical evacuation by air. And check the policy limit is high enough to cover a flight to Lisbon, Libreville or Johannesburg. Carry a basic first aid kit, any prescription medication you need for the whole trip. And proof of yellow fever vaccination, which is required for entry. Malaria is present on both islands, so speak to a travel clinic about prophylaxis before you fly. Cash matters more than cards here. The local currency is the dobra and many guesthouses, taxis and restaurants do not take cards. ATMs exist in Sao Tome city but can run dry or reject foreign cards without warning, so bring euros to change. Driving is on the right, but roads are narrow, goats and children share the tarmac, and night driving outside towns is best avoided. For inter-island travel, build a buffer day into your schedule in case the Principe flight or ferry is delayed by weather. Register your trip details with your own foreign ministry if that service is offered, and keep a copy of your passport separate from the original.