The Cameroonian remains the favourite to win, but faces a mounting challenge from little-known Madagascan Football Association president Ahmad, who goes by just a single name, with moves to oust the controversial 70-year-old gathering pace.
Hayatou has been president of CAF since 1988, a near three-decade reign that at times has been controversial, and those scandals may finally be coming back to haunt him.
But perhaps his biggest error was to back the wrong horse in the Fifa elections last year, instructing African nations to vote for Sheikh Salman Bin Ebrahim Al Khalifa of Bahrain against eventual winner Giovanni Infantino.
Now visibly ageing and beset by health issues, Hayatou remains determined to cling to power. Over the last three decades, challenges to his tenure have been dispatched by a myriad of masterfully Machiavellian moves, usually involving changing the statutes or rules to ruthlessly dispose of any potential opposition.
Standing in Hayatou’s way ahead of these elections was an age limit that disqualified any office bearer from serving past the age of 70.
It forced many of Hayatou’s executive committee contemporaries to exit stage left, but now with the possibility of his own forced retirement, CAF suddenly felt the need to change their statues.
So, in an emphatic display of the complete control he had over CAF, all 54 member associations at the organisation’s 2015 Congress in Cairo voted for a statutes amendment to scrap the age limit.
Disposed of inside five minutes, it left Hayatou free to seek an eighth term in office.
But in the two years since, it is clear that he does not have as much of a hold over the continent as he once did.
This is only the fourth time that Hayatou has been challenged for African football’s top post, and only two of the previous occasions actually went to a vote. First, against the eccentric Angola Armando Machedo in 2000 (receiving four votes to Hayatou’s 47) and the second versus Ismail Bhamjee of Botswana (46-6) in 2004.
Jacques Anouma from Côte d’Ivoire had sought to go up against the Cameroonian in 2013, but again Hayatou sensed danger and cut his chances before a vote could be held.
He called for an extraordinary congress in the Seychelles and easily passed a new rule dictating future presidents can only be chosen from the ranks of the voting CAF executive committee members.
Anouma was a committee member but only by virtue of the fact he had an automatic place on the African body because he served as one of the continent’s representatives in the Fifa executive. He had no vote on the CAF body and was thus disqualified from the CAF election.
Hayatou was born into privilege in the town of Garoua in what was then French Cameroon, the son of a local sultan. His brother Sadou would go on to be prime minister of Cameroon and members of the family found lofty positions in society easy to come by.
The young Issa was a budding sportsman, earning national colours in basketball and athletics, where he was a 400- and 800-metre runner.
He was just 28 years old when he became secretary-general of the Cameroon Football Association, and by 1986 was elevated to chairman, the same year he was chosen to sit in the CAF executive committee.
Within two years he was elected CAF president at a low-key congress in Morocco following the retirement of Ethiopia’s Ydnekatchew Tessema, and has remained in power ever since.
He was elected to the Fifa executive committee in 1990 and within a further two years was president of the organising committee of the Olympic Football Tournaments for Fifa, a post he held until 2006.
He has also been a member of the International Olympic Committee since 2001.
There have been a number of allegations of wrong-doing down the years, but so far none have led to a criminal prosecution.
Investigative journalist Andrew Jennings stated in 2010 that Hayatou had in the 1990s received bribes in relation to the awarding of television rights for World Cups, something the Cameroonian has denied.
A year later the English Sunday Times claimed that Hayatou had received $1.5-million in bribes from Qatar to ensure he, and presumably the African bloc, voted in favour of the Middle East country to host the 2022 World Cup.
In January he was referred to Egyptian prosecutors, accused of abusing his powers in relation to a deal awarding the broadcast rights to several African football tournaments to Lagardere Sports.
It is claimed that the tender process for awarding the contracts was not transparent and open to competition. Hayatou has denied any wrong-doing.
Despite all the mud being slung at him, Hayatou has continued to progress and actually held the highest office in football when he was named acting Fifa president following the banning of Sepp Blatter and prior to the elections in which Infantino took power last year.
Hayatou, backed by Uefa, had previously challenged Blatter for the Fifa presidency in 2002, but lost 139-56.