Purpose: This study investigates the difficulties the health care service providers encounter in the quest of rendering preconception counselling services in Ghana. Methodology: The study employed descriptive survey design with the use of both qualitative and quantitative research approaches using questionnaire as the main tool. The study employed simple random sampling to sampled 135 out of 675 health care service providers from 23 health facilities in the Bole District of the Savanna Region in Ghana. The quantitative data obtained for the study was analysed using Statistical Package for Social Solution (SPSS) whilst the qualitative data were subjected to descriptive and narrative discussion. Findings: The study revealed that, health care practitioners need continuous training programme. It also became clear that, there no any clear national guideline or policy on preconception counselling in Ghana. It came to light that, the healthcare service providers face a lot of difficulties to capture women of child bearing age to offer them the services. Inadequate knowledge and expertise to effectively offer the preconception counselling services was also identified as a challenge. Recommendations: The study therefore recommend that the Ministry of Health and Ghana Health Service should come out with a clear policy guideline on preconception counselling and also provide an intensive training for the health care professionals. The health care providers should also be provided with the needed resources to embark on sensitisation and advocacy campaigns to create the awareness for women of childbearing age to appreciate the need for preconception and genetic carrier risk counselling.