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Black immigrant young adults of African descent (BIYAD), defined here as African-born Black young adults aged 18 to 34 living in Canada, are a growing yet persistently underserved population facing mental health challenges at a formative life stage. Despite elevated distress and documented underutilisation of services, they remain largely absent from the Canadian literature as a distinct group. This narrative review synthesises evidence on the demographic context, intersecting identities and multilevel barriers shaping mental health access among BIYAD. Drawing on intersectionality theory and Levesque's framework of healthcare access, it maps race, immigration status, and developmental stage against the five dimensions of access, recording for each whether the evidence is direct or extended to this population. Black youth in Canada disproportionately enter services through emergency and forensic pathways, reflecting systemic failures in preventative and culturally responsive care. Recurrent barriers include stigma, cultural incompatibility, unaffordable outpatient services, prolonged wait times and underrepresentation of Black professionals. Because these patterns hold across both a long-established Canadian-born Black community and a predominantly African immigrant-origin population, they are extended to BIYAD on the reasoning that the operative mechanism is racialization rather than migration. Barriers arising from migration itself, and its interaction with racialization, remain undocumented for this group, which reflects a gap in measurement as much as in attention. The review calls for research disaggregating BIYAD from broader Black and immigrant populations, culturally responsive service reform, and race-conscious policy action.