Lakes around the world, including Ghana’s Lake Volta, are facing insidious threats from pollutants due to high dependency on aquatic ecosystems. Cage aquaculture is expanding across Africa because of its potential to address food insecurity, provide livelihoods, and boost local economies. However, the uncontrolled expansion of cage aquaculture can have significant negative impacts on water resources, including environmental footprints that threaten biodiversity. Given the intensification of cage aquaculture for tilapia farming on Lake Volta, we advocate for a transition to inland-integrated aquaculture systems that promote circularity. Strengthening stakeholder collaboration is essential for enhancing competence in mapping inland aquaculture areas, identifying eco-friendly alternatives and reinforcing aquaculture regulations, with particular emphasis on cage culture on Lake Volta. These strategies can reduce the pressures imposed by tilapia cage farms on the lake while promoting best management practices. Additionally, capacity building must be an ongoing process to address knowledge gaps, including the development of effective preparedness plans executed during emergencies. The ongoing pollution from illegal mining in the Black Volta River, a tributary of Lake Volta, along with endemic diseases in the lake, further compounds fish health and welfare issues. This underscores the urgent need to implement inland transition strategies to protect the lake, mitigate disease spread, and ensure safe fish food production.