In this era of rationalism, 'good' urban planning and management decisions are deemed to be those that are able to identify a tangible balance of environmental benefits (i.e., safeguarding environmental resources such as nature reserves and open spaces, and health) and socio-economic development, with little or no negative implications for urban sustainability. Yet, research indicates that urban Ghana is faced with rapid depletion of environmental resources amidst burgeoning urbanisation and climate change. Based on a review of relevant and related literature, this paper explores the implications of this dilemma for the future of urban Ghana. It examines the environmental problems confronting urban Ghana by: (i) analysing the factors that predispose urban Ghana to environmental threats; (ii) understanding the influence of human-induced activities and natural occurrences on urban environmental resources; (iii) discussing environmental protection in terms of sustainable urban development in Ghana; and (iv) presenting policy implications of the environmental problems in Ghana. Findings indicate that high demographics, defunct planning system, and rising poverty predispose environmental depletion in urban Ghana. Anthropogenic actions (e.g., pollution, poverty, and urban growth) and natural events (e.g., flooding, drought, and windstorms) have negatively changed the geography of the urban environment. This paper advocates the adoption and implementation of the values (e.g., inclusiveness, equity, pro-poor) of the sustainable urban development concept.