Ghana has experienced a significant decline in its total fertility rate (TFR) over the past two decades. Recent demographic studies have focused on the factors contributing to this fertility transition. This chapter describes the levels, trends, and patterns of fertility in Ghana from the Ghana Demographic and Health Surveys (GDHS), 1988 to 2022. Understanding fertility trends and patterns is essential for informing the design of targeted sustainable development policy interventions. The data were analysed using descriptive techniques, which included simple tabulations and percentages to present fertility indicators by sociodemographic characteristics. Our findings indicate that the fertility decline, which began in the 1980s, has stalled, with TFR staying around 4.0 since 2008. This suggests a potential stagnation in Ghana’s demographic transition. Furthermore, the mean age at childbearing has shown considerable stability, averaging 30 years between 1988 and 2022. Specifically, women with secondary and higher levels of education consistently exhibit lower fertility rates. Additionally, improvements in household wealth, urbanisation, and the increasing age of first marriage have all contributed to the observed decline in fertility. The chapter concludes that enhancing women’s access to formal education remains crucial for sustaining the fertility transition in Ghana. Policies and programmes should aim to empower women by taking advantage of the Free Senior High School programme to educate more females.