Objective This study aimed to examine the prevailing driver seatbelt compliance at the Madina Zongo junction in Accra, Ghana. Methods An unobtrusive observational survey was conducted from 6 to 8 am and 5 to 7 pm on weekdays at randomly designated locations near the junction. A total of 3,054 vehicles were observed throughout the observation period. The data collected were analyzed with SPSS version 26. Cross-tabulations and Pearson’s Chi-square test were employed for thorough analysis. Results The study revealed an overall seatbelt compliance rate of slightly over half (54.1%) among drivers, with the following breakdowns in various vehicle categories: large buses (76.2%), medium buses (98.1%), minibuses (44.0%), private cars (70.5%), taxi/uber (53.0%), and trucks (41.1%). Notably, seatbelt compliance was higher among females at 98.4%, compared to males at 49.2%. The study also identified a correlation between driver’s gender and vehicle type with seatbelt compliance. Conversely, no significant association was found between seatbelt compliance and either the time of day or day of the week. Conclusions The study offers significant findings regarding seatbelt usage trends at the Madina Zongo junction in Accra. These insights provide a basis for recommending targeted interventions such as policy decisions, public health campaigns, communication strategies, better enforcement, and road safety training programs. These interventions aim to raise awareness of unsafe attitudes and behaviors among drivers to improve seatbelt compliance and ultimately enhance road safety for all road users.