Re-excavation of Akyekyema Bour and Apreku rock shelters on the Kwahu Plateau, Ghana, has revealed the existence of distinctive lithic assemblages comprising both microliths and macroliths, with associated radiocarbon dates spanning the early to late second millennium ad. The typo-technological attributes of the stone tools produced at these sites remain relatively constant until the disappearance of this technology during the seventeenth century ad, or later. Lithic technology also persists at widely distributed open-air sites and rock shelters across West Africa that date within the last two millennia. The Kwahu macrolithic assemblages are unique on the plateau and in the wider region, as sites with comparable lithic technology supposedly date no later than the mid-first millennium ad. From the later first millennium ad, profound socioeconomic and technological changes began to reshape the societies of the forested and coastal region of Ghana and beyond, with, for example, the emergence of complex agrarian societies and development of long-distance trade networks, e.g., the Atlantic trade. Yet, the localised variability and continuity evident in the lithic and pottery assemblage(s) at the study sites, and Bosumpra Cave, demonstrate that aspects of tradition, belief and identity also persisted, thus enabling insight into aspects of society, economy, technology, and the history of the Akan-speaking people within the forested zone during the second millennium ad.