The East African Rift System is one of the most volcanically and tectonically active regions in the world, with an estimated geothermal energy potential of about 20,000 MW. However, among the countries in the region, only Kenya’s energy system has a significant share of geothermal energy, with an installed electrical power capacity of about 861 MWe, primarily utilizing high enthalpy sources for power generation. Low to medium enthalpy resources in the East African region are currently mostly unutilized. The utilization of these resources would support a sustainable development of the region, including the industry, agriculture, indoor climate, wellness tourism and other sectors. However, more research is required to ensure the optimal use of low and medium temperature heat sources in East Africa. In this paper we present a review of on-going research focusing on the utilisation of low to medium enthalpy geothermal sources in the East African region. We present the state-of-the-art related to the evaluation of the geothermal reservoirs’ potential and multi-generation energy systems powered by geothermal energy. Further, we discuss the challenges of the existing training programs and the need for an appropriate policy framework promoting the utilization of geothermal energy in East Africa. Finally, possible research directions are discussed.