Despite the use of environmental and social impact assessments for road projects, severe social impacts continue to occur. We discuss the social impacts associated with the construction, upgrading, widening and/or rehabilitation of roads in Sub-Saharan Africa. In addition to a literature review, we analysed 10 road projects in Uganda by examining project planning documents, and undertaking in-depth interviews, group interviews and field visits. While there were some benefits from these road projects, especially dust reduction where roads became sealed, the significant land acquisition necessary for these linear projects has led to physical displacement, economic displacement, and disruption to the livelihoods of local people. Other issues included: inadequate community engagement; delayed payment of compensation and inadequate compensation; gender-based violence; poor road construction practice causing community safety concerns; project-induced in-migration or influx; sexual harassment; impacts on children; and issues around sex work. The lack of local community acceptance (social licence to operate) of the projects resulted in construction delays and increased costs. For more acceptable road projects, better community engagement, improved planning and management, and adequate funding for resettlement and compensation are essential.