Pregnancy among adolescent girls is a public health problem globally and especially in developing countries. Its occurrence can be prevented with the correct and consistent use of effective contraceptive methods. This study explored the personal determinants of hormonal contraceptive uptake and consistent use among adolescent girls as evidence for informing effective hormonal contraceptive use interventions among them. In-depth interviews were carried out among 16 girls aged 15 to 19 years with hormonal contraceptive experience between April and June 2022 in Kintampo, Ghana. Results showed that knowledge on hormonal contraceptive types and sources of obtaining them, organizing hormonal contraceptive uptake and self-efficacy in getting access, hormonal contraceptive use decision-making, and disclosure of hormonal contraceptive use were important factors explaining uptake and consistent hormonal contraceptive use among adolescent girls in this study. Also, coping mechanisms and skills for accessing and using hormonal contraceptives, attitude toward hormonal contraceptives, and risk perception toward pregnancy influence the uptake and consistent use of hormonal contraceptives. Participants in this study were resilient and highly in favor of hormonal contraceptive use. They have demonstrated that it is possible for adolescent girls to use hormonal contraceptives and use them consistently if interventions are targeted at their attitude to hormonal contraceptives, their self-efficacy, decision-making skills, coping skills, and pregnancy risk perception, among others.