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This study analyzed the determinants of households’ access and use of improved water for domestic purposes in the Northern Region of Ghana, using a survey of 356 households selected using the multi-stage sampling technique. The Logit Regression Model, Multinomial Regression Model and the Kendell’s Coefficient of Concordance were the analytical methods employed. The study revealed that the factors that influenced households’ choice of water source were level of education, sex of household head, household income, and households’ size, especially the number of children in the house and distance to water source. Irregular supply of improved water, an inadequate source of improved water and long queue at water points, in that order of severity were reported as the major constraints to households’ access to improved water. The study recommends an income diversification campaign to encourage households to diversify in order to raise their purchasing power for improved water.