Climate change is projected to have an impact on disease abundance and a geographic shift in the prevalence of many vector borne diseases like schistosomiasis and malaria. Schistosomiasis is one of the 13 diseases that the WHO has classified as Neglected Tropical Diseases (NTDs) which currently affects some 200 million people and another 600 million people are at risk globally. Despite the high prevalence and its associated effects like anaemia and bladder cancer, it receives less attention and little is currently known about the pattern of spread and the potential links to climate change. This study examined the influence of climate variability/change on schistosomiasis prevalence in endemic communities. Also, community knowledge and perceptions of schistosomiasis infection, as well as coping strategies were examined. The study employed a mixed method involving qualitative and quantitative methodologies. Schistosomiasis epidemiological data from the Centre for Health Information Management (CHIM) and climatic data the Ghana Meteorological Agency were used. The primary data collection involved focus group discussion, in- depth interviews and participant observation in two communities. The results of the quantitative data analysis showed a significant positive correlation between total rainfall and schistosomiasis (r=0.410, p<0.05). The correlation between rainy days and schistosomiasis is not significant (r=0.263, p>0.138). Minimum and maximum temperatures correlated negatively with schistosomiasis (r=-0.717, p<0.05) and (r=-0.631, p<0.05) respectively. Moreover, there was no significant difference between the effect of moderate rainfall and high rainfall on schistosomiasis prevalence (X 2 =2.098, df=3, p>0.5). It was also found that the maximum temperature Granger- causes a reduction in schistosomiasis. Also, the knowledge and perceptions of climate change was consistent with the empirical data and that for schistosomiasis was similar to biomedical explanations. There had been control and prevention interventions such as school-based education, screening and treatment which were mainly targeted towards school children to the neglect of the other vulnerable groups. The study recommends that community members be involved in prevention and control programmes, so that their knowledge and perceptions can be integrated into the implementation strategies.