Afropessimism is a critical framework that is often used to analyse anti-Black violence and its deep entrenchment within systems and structures that perpetuate Black subjugation. By conceptualising Black life as 'non-life', afropessimism examines how anti-Black violence shapes health disparities, influencing who is deemed worthy of care and underscoring the systemic nature of this (d)evaluation. This framework holds significant potential for anti-racist efforts that aim to address Black health disparities by exposing their root causes. However, afropessimism's central claim-that Black people are not only excluded from the category of the 'human' but are also positioned as its antithesis-poses challenges for anti-racist strategies focussed on affirming recognitions of Black humanity to achieve health equity. This paper critically investigates the role of afropessimism in anti-racist health promotion by examining divergent perspectives within its schools of thought. While all scholars who use afropessimist frameworks critically interrogate the systemic inequities that harm Black populations, they differ in their views on the potential for Black life within and beyond current anti-Black systems and structures. These differences lead to varying implications for advancing anti-racist health initiatives and promoting health justice through afropessimism. By analysing how afropessimism may inform anti-racist health frameworks, this paper explores how its distinct theoretical perspectives can enrich, challenge, and constrain efforts to dismantle racial health inequities.