The growing collection of used textiles has increased the demand for more knowledge about current handling and treatment, in order to facilitate improvements of textile waste management systems. A key question is whether second-hand textiles actually replace new items, and it is of particular importance in order to assess the environmental impact of textile handling and treatment. This study determined the replacement rate through face-to-face questionnaire surveys conducted in Angola, Malawi and Mozambique. In total, 3485 respondents and 14,190 purchased second-hand textile items formed the basis for determining replacement rates, namely 63 ± 6% in Angola, 35 ± 1% in Malawi and 37 ± 5% for Mozambique, and according to a set of main categories (clothing, household textiles and other textile products) and product types. The rates varied between product types, but the relatively low replacement rates were surprising and possibly caused by the respondents' limited purchasing power, i.e. that buying new textile items was not an option. This was supported by several findings, such as respondents’ wardrobes consisting largely of second-hand clothes and the purchase of second-hand items to upgrade or to replace damaged items.