Abstract In the context of increased rural-urban migration, social exclusion of some of the recent urban arrivals and the sharp change in life style in urban communities, some of the most critical health problems of older people may be found in cities. This paper attempts to characterize the general health condition of older women (50 years and over) in Accra, Ghana's capital city. It employs secondary analysis of data from the Accra Women's Survey, 2004. The findings broadly suggest that an overwhelming majority of older women lack basic education, are not in any form of paid employment, and are widowed, separated or divorced. 3% the women rate their general health condition as excellent, 18% as very good, 41% as good. 35 % believe there health condition has worsened in the last 12 months. Such perception of deterioration in health status is associated with increasing age. Almost 4 in 5 older women have difficulty climbing stairs and have pains in their joints; 53 % have malaria, 42 % have high blood pressure, and 8% have diabetes. Thus, older women in urban Ghana are experiencing a double burden of disease. They are afflicted with the common tropical diseases such as malaria, while simultaneously experiencing chronic illnesses such as hypertension and diabetes. Older persons' concerns have remained marginal to the major social and economic debates in the country. Health services need to be oriented to responding to chronic as well as infectious diseases among ageing individuals.