Household interviews were used to survey 21,105 persons living in 431 urban and rural sites in Ghana, to determine the nature and extent of their occupational injuries. Annual occupational injury rates were 11.5 injuries/1000 persons in the urban areas and 44.9/1000 in the rural areas. Occupational injuries had higher mortality, longer disability, and higher treatment costs than non-occupational injuries. There were substantial occupational injury rates among children, especially in rural areas. In the urban areas, the largest numbers of injuries were to drivers (12.7% of urban occupational injuries) and traders (19.4%), most of which were road-traffic-related. In the rural areas, most injuries (71.6%) were to farm workers. Occupational injuries are a substantial burden in Ghana. Priorities include improving road safety and improving the prevention and treatment of injuries from nonmechanized farming.