The potential for integrating aquaculture with agriculture has been widely recognized as a means of improving the use of inputs, diversifying output and economic opportunity, and enabling smallholder producers to maintain and strengthen livelihoods. This paper describes the outcomes of this approach and explains the extent to which it has been taken up and has led to sustained and self-generated capacity. Based in particular on experience in Malawi, Ghana and Cameroon, it also considers implications more widely in the region. The overall picture is that this is a partial and still emerging success story, linked as much with the social and economic drivers surrounding smallholder farmers as with the development support approach adopted.