Background: In Ghana, sex education has been a part of the post-independence school curriculum, aimed to fill a significant knowledge gap, prepare them to make healthy sexual choices. However, sex education is not apparent in the schools. We aimed to understand senior high school adolescents’ knowledge, perspectives on contraceptive use, and attitude towards sexual health education in the Upper East Region of Ghana. Methods: This was a descriptive study involving 329 students (from 15 - 19) comprising males (n = 166, 50.5%) and females (n = 163, 49.5%) from a senior high school in the Upper East Region of Ghana. Eighteen-point Likert scale items with four-point responses—strongly agree, agree, disagree, and strongly disagree—were used to measure students’ perspectives in the Upper East Region, Ghana. Results: The results show that most students (n = 150, 45.6%) strongly disagreed with reporting first developmental changes to parents and teachers. For students who agree (n = 101, 30.7%), more males than females (55.4% versus 44.6%) favoured the recommendation. About 42% strongly disagreed with seeking professional counsel on contraceptive use, with more (52.6%) females in support of non-use of the advice of health personnel. Similarly, most respondents sought information on sex education from peers and were more comfortable associating and sharing adolescent experiences than with parents and teachers. Conclusion: There is inadequate knowledge of the adolescent youth on sexual health issues. Therefore, we recommend that qualitative studies be conducted to understand the students’ views on sexual and reproductive health knowledge and access to services.