Guinea’s strong population growth is a result of declining mortality rates and sustained elevated fertility. The population growth rate was somewhat tempered in the 2000s because of a period of net outmigration. Although life expectancy and mortality rates have improved over the last two decades, the nearly universal practice of female genital cutting continues to contribute to high infant and maternal mortality rates. Guinea’s total fertility remains high at about 5 children per woman as of 2022 because of the ongoing preference for larger families, low contraceptive usage and availability, a lack of educational attainment and empowerment among women, and poverty. A lack of literacy and vocational training programs limit job prospects for youths, but even those with university degrees often have no option but to work in the informal sector. About 60% of the country’s large youth population is unemployed.

Tensions and refugees have spilled over Guinea’s borders with Sierra Leone, Liberia, and Cote d’Ivoire. During the 1990s Guinea harbored as many as half a million refugees from Sierra Leone and Liberia, more refugees than any other African country for much of that decade. About half sought refuge in the volatile "Parrot’s Beak" region of southwest Guinea, a wedge of land jutting into Sierra Leone near the Liberian border. Many were relocated within Guinea in the early 2000s because the area suffered repeated cross-border attacks from various government and rebel forces, as well as anti-refugee violence.