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 twentieth-century Ghana including railway construction, cocoa production, missionary activities, and urbanization. We find significant height gains in cocoa producing areas, whereas heights decreased with urbanization.