A study to determine the causes of deafness was done in Kumasi in central Ghana. A total of 128 deaf children aged between 1-5 years referred to the Ear, Nose and Throat clinic at the Komfo Anokye Teaching Hospital (KATH) were seen from January 1992 to June 1993. The procedure adopted included exploration and assessment of individual medical history, otoscopy, pre-audiometric and audiometric evaluation. It turns out that 66(51.5%) had congenital sensorineural hearing loss (CSHL), while the remaining 62(48.5%) had acquired sensorineural hearing loss (ASHL). Of the 66 congenital cases, 44 was due to unknown factors, while the rest were due to post-natal convulsion, measles, meningitis, mumps, fever and jaundice. Results of free-field tests were available in 116 children. Of these, 90 cases had a profound SHL while 38 had a severe-profound SHL. Again, of the 90 children with profound SHL, 56 was due to congenital factors, while the remaining 34 originated from acquired causes. Thus, the cases listed under CSHL showed a distinctly higher incidence of profound deafness. Primary prevention measures against diseases that cause deafness would be the most logical and practical way of helping to reduce the incidence of deafness in Ghana.