Injury is a significant health problem in many less developed countries. However, strategies for dealing with it have been only minimally addressed. We ought to assess the pattern of health care utilization by injured persons in rural Ghana. We thus hoped to provide data that would assist in strengthening injury treatment in this setting. Using household interviews, we surveyed 9442 person. We sought information on any injury during the previous year that resulted in one or more days of disability. Injured persons were interviewed regarding the mechanism of injury, treatment obtained and length of disability. During the previous year, 923 nonfatal injuries were reported. Half the injured persons (49%) received no formal medical care. When treatment was received, it was primarily delivered by a non-doctor staffed primary health care (PHC) clinic. Such clinics provided treatment for 30% of all injured persons (58% of those receiving formal medical care). Twenty percent of the injured received hospital-based care (39% of those receiving formal medical care). Among those using hospitals, the majority (92%) used district hospitals. In this setting, efforts to improve injury treatment should include district hospitals and PHC clinics. At both there is a need to advance the concept of 'essential' injury treatment services, addressing equipment, supplies and training.