Adaptation action is essential to achieving and safeguarding development outcomes in the face of more frequent and intense climate hazards. This report is the culmination of a 21-month partnership between the Government of Ghana (MESTI), the Global Center for Adaptation (GCA), the University of Oxford, the United Nations Office for Project Services (UNOPS) and the United Nations Environment Programme (UNEP) to identify and propose solutions to address priority adaptation needs in Ghana. Using novel modelling and assessment tools, and through an extensive stakeholder consultation process, it provides an assessment of risk of climate hazard on national infrastructure systems. Next, it develops a roadmap for addressing risks through targeted adaptation options in the built and natural environments, including nature-based solutions. The roadmap also defines institutional interventions required to enhance the enabling environment that ensures the optimum effectiveness of adaptation measures in the country. It is aligned with Ghana’s national development objectives to advance progress towards the Sustainable Development Goals (SDGs), the Paris Agreement on climate change, and gender and inclusivity objectives. The proposed 35 prioritised adaptation options provide opportunities for funders and investors to invest in Ghana’s future, offering impactful, evidence-based adaptation projects and enabling environment interventions backed by robust research and analysis.