Abstract mong adults, morbidity due to the pathology of late chronic schistosomiasis infection has been reported frequently. Nevertheless, school-aged children are the main targets of schistosomiasis-control programs, because epidemiological studies often find infection to be more prevalent among school-aged children than adults. This study sought to show the importance of schistosomiasis among adult populations in the Volta Basin of Ghana. A total of 3,301 study subjects were randomly selected from 30 rural riparian communities on the Afram and Lower Volta Basin of Ghana. Urine analysis was used to determine urinary schistosomiasis infection. Subjects were also interviewed using a structured questionnaire to assess their knowledge, perceptions, and practices, in relation to the disease. The results revealed an overall prevalence rate of 46.5%. Communities on the Afram arm were 2.4 times more likely to be infected with urinary schistosomiasis than those in the Lower Volta Basin. Gender variation in prevalence was biased towards males (56.5%) compared with females (36.9%). Age-stratified prevalence was highest (73.0%) in the 15-19 year age group and decreased with increasing age to 20.8% among subjects> 49 years. Intensity of infection was generally low, and egg counts ranged between 1-1,244 eggs/10 ml urine. The arithmetic mean egg count was 0.43 eggs/10 ml of urine. Most subjects (53.4%) had no schistosome eggs in urine, 38.1% had light infections (≤ 50 eggs/10 ml urine) and 8.5% had heavy infections (≥ 50 eggs/10 ml urine). The study also demonstrated a high level of awareness of schistosomiasis as a water-borne disease, but limited knowledge of its transmission. The symptom, hematuria, was strongly associated with knowledge of schistosomiasis, whereas educational level was not. The study also revealed actions taken when infected included; doing nothing about the condition, self-medication, and visiting health facilities. This research highlights that the prevalence of schistosomiasis among adults is not transient. It is recommended that the risk groups in Ghana include adult populations in communities on the Afram arm of the Volta.