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Background: Maxillofacial fractures in the paediatric population are peculiar in risks, management, and potential complications. Aim: To determine the pattern, psychological distress to parents, and economic cost of paediatric maxillofacial fractures in Ghana. Design: This study combined a retrospective evaluation with a cross‐sectional cost‐of‐illness (COI) analysis to describe the pattern and economic cost of paediatric maxillofacial fractures in Ghana. The DASS 21 was used to assess psychological distress to parents. Descriptive summaries were generated, and cross‐tabulations done, with consequent tests of associations. Results: In all, 253 patients were included in the study, with 68 households responding to the COI evaluation. Consisting of 179 (70.8%) males and 74 (29.2%) females, the ages ranged from 10 months to 17 years (mean age of 9.0 ± 5.0 years). Maxillofacial fractures frequently resulted from falls (56.5%), while traffic injuries accounted for 27.3%. The average household cost for paediatric maxillofacial fractures in Ghana was US$ 148.77, with the direct cost component accounting for 76% of this amount. At least half of the parents had some degree of psychological distress from the injury sustained. Conclusion: Knowledge of the pattern and disease burden of maxillofacial fractures in children is vital in informing preventive strategies, especially for evolving health systems in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]