OBJECTIVE: To assess the knowledge and use of emergency contraception (EC) and to identify factors associated with the perceptions of EC use among female college students in Ghana. DESIGN: A descriptive cross-sectional study. SETTING: Nursing-midwifery and teacher-training colleges in Ghana. PARTICIPANTS: A convenience sample of 400 female college students. METHODS: Data were collected using a four-part structured questionnaire. Descriptive statistics, chi-square tests, and univariable and multivariable regression analyses were performed. RESULTS: Most participants (n = 352
88.0%) reported hearing about EC. However, only 10.0% (n = 40) knew about the copper-bearing intrauterine device as an EC. Friends (n = 216
54.0%) were reportedly the primary source of information about EC. Concerns about serious adverse effects were the top reason for not using EC (n = 354
88.5%). In contrast, facilitators for use included availability, easy access, partner agreement, affordability, and family discussions. Teacher-training college students who were single were more likely to have negative perceptions of EC use than nursing-midwifery students who were married or living with a partner. CONCLUSION: Although the results highlight the limited knowledge and use of EC among female college students in Ghana, they also point to the potential for more effective education to improve knowledge and use of EC.