OBJECTIVE: To determine the proportions of male and female teenagers aged 15-19 years who have ever been involved in pregnancy, and to examine factors associated with involvement in teenage pregnancy in the Ejisu-Juabeng district of Ghana. METHODS: In a household-based cross-sectional survey, 481 randomly selected male and female teenagers were enrolled between August 3 and September 17, 2009. Study variables included demographics; sexual exposure; contraceptive use; and involvement in pregnancy, childbirth, and induced abortion. Multivariable multinomial logistic regression analyses were used to examine the association between involvement in pregnancy, and the background and reproductive profiles of the respondents via SPSS version 16.0. RESULTS: Both the mean and median ages of the respondents were 17.2 years. One-third of respondents lived with both parents, and one-third lived with single mothers. The median age of sexual debut was 16.0 years. Approximately 58% of sexually experienced females had been pregnant, and 37% had had an induced abortion. Age at sexual debut, gender, and being out of school were significantly associated with involvement in teenage pregnancy, whereas residential status, relationship with first partner, and contraceptive use were not. CONCLUSION: Keeping adolescents enrolled in school might reduce their risk of involvement in pregnancy in the Ejisu-Juabeng district of Ghana.