An association of high sunspot numbers with rises in the level of Lake Victoria, East Africa, has been the focus of many investigations and vigorous debate during the last century. In this paper, we show that peaks in the ~11-year sunspot cycle were accompanied by Victoria level maxima throughout the 20th century, due to the occurrence of positive rainfall anomalies ~1 year before solar maxima. Similar patterns also occurred in at least five other East African lakes, which indicates that these sunspot-rainfall relationships were broadly regional in scale. Although irradiance fluctuations associated with the sunspot cycle are weak, their effects on tropical rainfall could be amplified through interactions with sea surface temperatures and atmospheric circulation systems, including ENSO. If this Sun-rainfall relationship persists in the future, then sunspot cycles can be used for long-term prediction of precipitation anomalies and associated outbreaks of insect-borne disease in much of East Africa. In that case, unusually wet rainy seasons and Rift Valley Fever epidemics should occur a year or so before the next solar maximum, which is expected to occur in 2011–2012 AD.