As food waste has a negative effect on food security, the present study sought to quantify household food waste along the rural-urban continuum in three South African mid-sized towns situated along an agro-ecological gradient. We quantified the types of foods and drinks that households threw away in the previous 48 hours and identified the causes of household food waste in the three sites. More households wasted prepared food (27%) than unprepared food (15%) and drinks (8%). However, households threw away greater quantities of unprepared food in the 48-hour recall period (268.6±610.1 g, 90% confidence interval: 175.5 to 361.7 g) compared to prepared food (121.0±132.4 g, 90% confidence interval: 100.8 to 141.3 g) and drinks (77.0±192.5 ml, 90% confidence interval: 47.7 to 106.4 ml). The estimated per capita food waste (5–10 kg of unprepared food waste, 3–4 kg of prepared food waste and 1–3 litres of drinks waste per person per year) overlaps with that estimated for other developing countries, but lower than most developed countries. However, the estimated average amount of food waste per person per year for this study (12.35 kg) was higher relative to that estimated for developing countries (8.5 kg per person per year). Household food waste was mainly a result of consumer behavior concerning food preparation and storage. Integrated approaches are required to address this developmental issue affecting South African societies, which include promoting sound food management to decrease household food waste. Also, increased awareness and educational campaigns for household food waste reduction interventions are discussed.