Welfare patterns in Ghana are characterised by widespread rural-urban disparities, with the welfare of rural residents lagging behind that of their urban counterparts. This paper argues that Ghana’s rural-urban welfare gap is influenced by the concentration – in urban areas – of business and industrial activity, and is sustained by the resultant inequalities in education, access to healthcare, and basic amenities. Given the pervasiveness and self-perpetuating nature of the disparities, the paper calls for a major policy initiative to address the imbalance.