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The West African city of Accra, home to over two million of Ghana’s 25 million residents, serves as the country’s political capital and economic centre. Since gaining independence in 1957, Ghana has made significant investments in road infrastructure and services. Road transportation accounts for the majority of passenger and freight traffic in the country. This paper discusses current street design practices and some of the challenges faced by designers and residents in Accra. After providing background information on the city’s urban form, transportation system and street design agencies, case studies are conducted on three of Accra’s thoroughfares. These case studies evaluate how current design practices, based on US and British standards, meet the needs of different street users. Each of the selected roads serves a different purpose within Accra’s transportation network. The case studies revealed that pedestrians and other non-motorised transport (NMT) users are largely neglected by current design practices.