This study examines the resilience strategies of adolescent girls in Nima, a suburb of Accra against teenage pregnancy. Specifically, it sought to find out the resilience pathways of adolescent girls against teenage pregnancy, determine the factors which influenced the resilience decision making process of these adolescent girls, examine the factors which help in building resilience and finally, understand the socio-cultural and economic factors which promote the building of resilience against teenage pregnancy. In the area of resilience studies in Ghana, this work is novel and thus adopted an explorative approach with a total sample of 120 girls. Questionnaires were administered and the data supplemented with five in-depth interviews. Using the EpiInfo software, the questionnaire data was analyzed to generate frequencies and the interviews analyzed based on themes. The results show multiple resilience pathways for adolescent girls in the face of teenage pregnancy but specific preference was placed on abstinence by „never been pregnant girls? whilst for those who have been pregnant before, the preferred pathway was the use of contraceptives. The major factor influencing the resilience decision making of the adolescent girls included education/future aspirations, personal values, family name, poverty and advice/ threats of parents. The study also found the girls to have good knowledge about their reproductive health rights which was explained to be important for dealing with their personal rights including reproductive rights and thereby helps in building their resilience. Although the involvement of parents was found to be very fundamental to the building of resilience, the study found that most of the parents were not communicating with their adolescent girls about issues relating to pregnancy and child birth. While some parents began to do so only with the onset of pregnancy, the help of significant adults not necessarily their biological parents (chemists, teachers, friends and relations) was found to be crucial for the resilience building. With regards to the socio-cultural and economic contexts that flourish resilience, most of the respondents identified parental/guardian advice as one of the measures to protect themselves from pregnancy. None of the respondents underwent any puberty rites but all they knew in relation to their menarche was thought at home. Based on the findings, two recommendations are being made for adolescent sexual and reproductive health policy making in Ghana, namely the need for a community based approach to educating and assisting adolescents to deal with pregnancy and pregnancy related issues, and further research in the area of adolescent sexual and reproductive health for a more comprehensive approach to be adapted in dealing with matters of adolescent sexuality and the reproductive intricacies that come with it.