Introduction: unsafe sexual behaviour among adolescents has drawn attention from all spheres of life because it makes them susceptible to different sexually transmitted diseases, unwanted pregnancies sometimes leading to abortion and a host of other health related problems. Objective: To analyse the sexual and reproductive health, particularly sexual activity and contraceptive use among adolescents in Kintampo, Ghana, to contribute to the limited data on adolescent sexual and reproductive health and provide recommendations. Method: A cross sectional survey among adolescents aged 15 to 19 was conducted in Kintampo, Ghana from October 2010 to May 2011. It used both qualitative and quantitative methods. A review of the relevant literature was also done. Results: 793 male (43.1%) and female (56.9%) adolescents participated in the study. Generally, knowledge of various elements of reproductive health apart from pregnancy was good at almost a 100%. Of all adolescents interviewed, 42% have been in a relationship. Of those, 95.2% have had sex; 90.4% (males) and (94%) females. Females had 1.3 times the odds of having sex compared to males. Consistent contraceptive use among adolescents was very poor (22.9%) as a result, 30.2% of adolescents have been pregnant with 34% of it ending in abortions and 42.5% live births. Results from the literature review were similar to the survey. Conclusion: Adolescent’s knowledge on pregnancy and contraception is limited. Unsafe sex is practiced among the sexually experienced
adolescents. Recommendation: A research for adolescents who have never been to school and for teachers is needed. Training and use of peer educators among other things are recommended to the Kintampo District health management team, the education service, and other stakeholders.