The Brazilians will face the Ghanaian club in a two-legged tie on the matchdays of 6-8 May and 17-18 May. As a losing team from the Champions League, Sundowns will play the first leg at home.
The eight winners of this round will go into the group stage of the CAF Confederatrion Cup proper.
Full CAF Confederation Cup play-off draw
Stade Malien vs FUS Rabat
Al Ahli Tripoli vs Misr Makkassa
Mamelodi Sundowns vs Medeama SC
Al Merreikh vs Kawkab Marrakesh
Young Africans vs GD Esperanca
TP Mazembe vs Stade Gabesien
Etoile du Sahel vs CF Mounana
MO Bejaia vs Esperance Tunis
CAF CC Hub: All the news, fixtures and results