The occurrence of mycotoxins in fermented maize dough and Ga Kenkey (an end product of maize dough fermentation) from major processing sites and markets in Accra was investigated. Experiments were then conducted to study the effects of spontaneous fermentation and cooking on aflatoxin and citrinin levels at two processing sites and under laboratory conditions. Occurrence of aflatoxins and citrinin was widespread with generally high concentrations. Levels as high as 289 μg kg −1 for total aflatoxins and 584 μg kg −1 for citrinin were recorded. Low amounts of ochratoxin A were detected and neither zearalenone nor α-zearalenol were found. Significant increases in aflatoxin levels were observed during the initial stages of fermentation. Furthermore, aflatoxins and citrinin were found to persist throughout the traditional steeping and fermentation processes. Cooking of fermented maize dough for 3 h, as done for Kenkey production, resulted in a 80% reduction in aflatoxins B 1 and G 1 levels, a 35% reduction in aflatoxins B 2 and G 2, and citrinin was no longer detectable.