Livestock production is central to rural livelihoods across sub-Saharan Africa, particularly in pastoral, agro-pastoral, and smallholder farming systems. Livestock provide food, income, savings, employment, insurance against shocks, manure, and social and cultural capital. However, the contribution of livestock to household welfare depends not only on production but also on households' ability to participate effectively in livestock markets and obtain fair returns. This review synthesizes literature published primarily between 2020 and 2026, with particular attention to pastoral and smallholder systems in East Africa. The evidence shows that market infrastructure, market information, producer organizations, transport, veterinary services, financial services, value addition, and improved market governance can reduce transaction costs, increase market participation, improve producer returns, and strengthen livelihood resilience. Evidence from Ethiopia demonstrates that improved livestock market sheds can increase smallholder earnings, while evidence from northern Kenya indicates that improvements in physical and communication infrastructure have strengthened market integration. However, market participation does not automatically improve welfare. Drought, climate variability, conflict, distress sales, weak bargaining power, gender inequalities, inadequate services, and restrictions on pastoral mobility can limit or reverse livelihood gains. Informal information networks, brokers, customary institutions, and cross-border trade also remain important in connecting remote producers to markets. The review therefore argues that livestock marketing should move beyond increasing sales volumes toward resilient, inclusive, equitable, and sustainable livestock value chains. Effective interventions should integrate market infrastructure, information, producer organization, animal health, finance, value addition, climate-risk management, gender empowerment, rangeland governance, conflict management, and predictable trade regulation.