Small scale mining continues to contribute significantly to the growth of Ghana's economy. However, the sector poses serious dangers to human health and the environment. Ground failures resulting from poorly supported stopes have led to injuries and fatalities in recent times. Dust and fumes from drilling and blasting of ore present health threats due to poor ventilation. Four prominent small scale underground mines were studied to identify the safety issues associated with small scale underground mining in Ghana. It is recognized that small scale underground mining in Ghana is inundated with unsafe acts and conditions including stope collapse, improper choice of working tools, absence of personal protective equipment and land degradation. Inadequate monitoring of the operations and lack of regulatory enforcement by the Minerals Commission of Ghana are major contributing factors to the environmental, safety and national security issues of the operations.