While Ghana is a classic case of economic growth in an agricultural-export colony, scholars have queried whether it was sustained, and how far its benefits were widely distributed, socially and regionally. Using height as a measure of human well-being we explore the evolution of living standards and regional inequality in Ghana from 1870 to 1980. Our findings suggest that, overall, living standards improved during colonial times and that a trend reversal occurred during the economic crisis in the 1973-83. In a regression analysis we test several covariates reflecting the major economic and social changes that took place in early twentiethcentury Ghana including railway construction, cocoa production, missionary activities, and urbanization. We find significant height gains in cocoa producing areas, whereas heights decreased with urbanization.