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Introduction: Emerging epidemiological evidence indicates rising adiposity among pediatric and adolescent populations in low- and middle-income countries, including those in sub-Saharan Africa. In Ghana, existing findings remain fragmented, with limited national-level data delineating age- and sex-specific trends. Strengthening empirical understanding of these patterns is essential for informing early-life prevention efforts and policy prioritization. Methods: A serial cross-sectional trend analysis was conducted using WHO Global Health Observatory data for Ghana from 1990–2022. Obesity was defined according to the WHO BMI-for-age criteria (> +2 SD). Prevalence estimates were disaggregated by age group (5–9, 10–14, 15–19 years) and sex. Descriptive analyses were performed in SPSS, and JoinPoint regression in R (NCI JoinPoint Software) was used to assess temporal trends and estimate annual percentage change.Results: The prevalence of obesity in Ghana was relatively high among children and adolescents aged 5–19 years between 1990 to 2022. Prevalence increased from 2.34% to 8.95% among boys and from 2.15% to 15.17% among girls aged 5–9 years. Among adolescents aged 10–19 years, the prevalence of obesity increased from 0.85% to 3.94% among boys and from 0.34% to 4.13% in girls. Trends were positive for subgroups (p < 0.001) in the AAPC analysis, ranging from most boys at 8.10% to the least young adolescents at 1.83%. Conclusion: Higher rates among younger children reveal an earlier onset of obesity, while narrowing sex differences reflect shifting behavioural and environmental influences.