The study examined the trends, determinants and health risks of adolescent fatherhood in countries where adolescent-girl pregnancy/motherhood are decried but with permissive male sexual latitude. Male-recode datasets of Demographic Health Survey (2000-2014) for Nigeria, Ethiopia and Zambia were used. The surveys were grouped into 3-Waves: Wave 1 (2000 and 2004); Wave 2 (2005 to 2009) and waves 3 (2010 to 2014). Ethiopia data consisted of 2000, 2005 and 2011 datasets; Nigeria‘s datasets included 2003, 2008 and 2013 while Zambia set of data featured 2002, 2007 and 2014. Wave-1 consists of 2000, 2002 and 2003 datasets; Wave-2 has 2005, 2007 and 2008 datasets while 2011, 2013 and 2014 data were used for Wave- 3. These files in each wave were grouped together and then combined into a single file. All data were weighted to ensure representation and analyses were split by countries and by waves to show the trends across .the years and for different countries. The study employed univariate, bivariate analysis and binary logistics that tested the log-odds of adolescent fatherhood with respect to selected sexual behaviour indices, individual and shared demographic variables. The results, among others, indicated that more than one out of every five adolescents has had two or more sexual partners. The likelihood of adolescent fatherhood is inversely related to condom use, but positively associated with increasing age at first cohabitation and higher number of multiple sexual partnerships (≥ 2) at odd-ratio of 1.673 and 1.769 in 2005/2009 and 2010/2014, respectively. Adolescents that have attained primary and tertiary education, and who are professionals and skilled labourers were 0.379, 0.313, 0.213 and 0.403 times (respectively) less likely to father a child as adolescent. The positive association between rural place of residence and adolescent fatherhood in the past shifted to urban residents in 2010/2014. The study concludes that enlightenment on the use of condom and testing for STIs/HIV and AIDS should be intensified. Increasing access to higher formal education including job opportunities is crucial to interventions towards boys’ vulnerability to fatherhood. The authors recommend support from policy-takers, governments and other stakeholders towards male adolescent access to higher education, skills acquisition, and campaigns against boys and girls cohabitations in the study locations and by extension sub-Saharan Africa in general.