This paper presents an overview of Ghana's sanitation situation post-Millennium Development Goals (MDGs). It specifically examines why the MDG target on sanitation was missed, Ghana's preparedness towards achieving the Sustainable Development Goals (SDGs) sanitation target, potential barriers and opportunities for the sanitation sector. An eight step policy analysis framework guided the review. The findings indicate that the low sanitation has largely been driven by rather complex economics, institutional and sociocultural factors including inadequate financial commitment, poor implementation of policies, bad attitude and perception towards sanitation and extensive use of shared and public toilets. Nevertheless, it was found that recent reforms and programmes in the sanitation sector such as the creation of new Sanitation and Water Resource Ministry, National Sanitation Authority (NSA), introduction of sanitation surcharges included in property tax, and programmes such as the Greater Accra Municipal Assembly sanitation and water project put Ghana in a better position to rapidly increase its coverage. However, efforts would have to be accelerated by forging partnerships with the private sector to provide efficient and low-cost technologies, financial schemes, human and technical resources for improved service delivery.