This study of the city of Accra examined the effects of increased urban temperatures on vegetable production and the adaptation strategies used by smallholder farmers. Using a mixed method approach, it was revealed that increasing temperatures in the city reduces the size of crops, slows crop maturity, and damages crops. The increased temperature has worked in tandem in reducing both outputs and incomes of urban vegetable farmers. Farmers were found to manage the effects of high temperatures by using agronomic strategies such as regular watering of plants, planting different types of vegetables that have different harvesting periods, and continuous planting to keep market share and guarantee household income. To build the resilience of the urban farmers to deal with urban heating effects on vegetable crop production, there is a need for adequate access to water, machines to pump water for plant watering, and more importantly the adoption of conservation agriculture practices including shade provision to minimize water loss. These findings contribute to the understanding of the extent to which elevated temperatures affect urban agriculture and its implications on farmers’ livelihoods, food prices, and food security in urban areas.