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In Sub-Saharan Africa, the West African region has highly diverse agro-climatic conditions, which grant the potential for a remarkable agricultural production of a great diversity of crops. Since the 1980s, the production volumes of most crops have grown vigorously for both domestic and export markets. Traditional food crops—such as rice, groundnuts and sorghum—have been replaced by cash crops, namely cashew. Among the main cashew production areas, West Africa is the most recent and dynamic in the world, accounting for 45% of the worldwide production of cashew nuts in 2015. In consequence, cashew cultivation has acquired an important position in West African smallholder farming, providing positive economic and social effects. In this paper, we provide an overview of the cashew production system in the West African region, using Guinea-Bissau as a case study. In particular, we present some viewpoints concerning the impact of cashew production and discuss how the strong dependence on a single cash crop can compromise the local livelihoods and food security. Finally, some insights are given towards the sustainable production of cashew in the face of the recent risks affecting the agricultural sector in West Africa.