A substantial decline in fertility levels in Ghana has occurred since the mid 1980s. This study uses data from the 1988 and the 1993 Ghana Demographic and Health Surveys to analyse the changing importance both of the proximate determinants of fertility and of demographic, socio-economic, cultural, and local factors affecting fertility in this West African country. The rising level of contraceptive use is found to be the main proximate cause of the decline in fertility. A woman's age, education, religion, place of residence and child mortality experience are found to be important factors affecting fertility indirectly. The most significant change in Ghanaian fertility has been the decline in fertility in urban areas outside the Greater Accra region.