Mauritius, as a high-income country in Sub-Saharan Africa, presents a distinct context for examining the adoption of innovative medical practices. Obstetrics and gynaecology, a critical specialty, serves as a pertinent case study for understanding how innovation is integrated within the region’s healthcare systems. This study aimed to compare the evolution of innovative approaches in obstetric and gynaecological practice in Mauritius. It sought to identify key technological and procedural advancements, and to analyse the drivers and barriers influencing their adoption within the local healthcare system. A comparative, mixed-methods study was conducted. Quantitative data on procedure rates and technology utilisation were collected from national health databases and hospital records. Qualitative data were gathered via semi-structured interviews with obstetrician-gynaecologists to capture experiential perspectives on clinical change. A clear trend towards minimally invasive surgery was identified, with laparoscopic procedures constituting a substantial proportion of major gynaecological surgeries. The integration of advanced foetal medicine screening and a centralised high-risk pregnancy management protocol were key innovations. However, adoption rates varied significantly between public and private healthcare sectors. Mauritius has integrated selected international innovations into obstetric and gynaecological care, aligning with its healthcare capacity. The pace and scope of adoption have been shaped by resource allocation, training pathways, and sectoral disparities. To promote equitable innovation, recommendations include developing standardised national guidelines for new techniques, investing in simulation-based training for public sector practitioners, and establishing a formal registry for procedural outcomes. medical innovation, obstetrics, gynaecology, Sub-Saharan Africa, Mauritius, comparative study This study provides a comparative analysis of medical innovation adoption within a high-income Sub-Saharan African setting, offering evidence on sectoral disparities that can inform health policy and specialist training programmes in similar contexts.