The overall aim of this study was to determine the pattern and prevalence of amblyopia and assess the treatment options used in a rural hospital in Ghana. The authors conducted a retrospective study from 2014-2018. Of 12,860 clinical records, 12,602 were eligible for the study. There were 258 cases of amblyopia. Mean presenting age of amblyopia patients was 24.2 ±16.1 years (1-75) and 52.3% were female. The highest frequency of amblyopia was in the 10-19 year age group. Overall prevalence for the time period was 2.04% with highest prevalence in 2014 of 2.57% and lowest in 2018 of 1.96%. Refractive amblyopia was most common (69.6%) followed by strabismic (17.8%) and anisometropic (51.6%). Two thirds were unilateral. Treatment was with glasses (54.3%) and strabismus surgery (1.9%). Referral for further treatment was in 14%. No patching or penalisation was given, possibly due to the expected poor compliance. The prevalence was lower than Caucasian populations and higher than Chinese populations. The reduced prevalence rate in more recent years may relate to improved primary eye care initiatives and adoption of the global action plan for prevention of blindness.