Over the years, urbanization has triggered complex spatial processes, such as the evolution of city-regions that defy traditional administrative regional boundaries. However, despite the growing body of research on city-regions, the evolution of this phenomenon and its implications for contemporary spatial governance remains a huge gap in urban planning literature, while approaches to their delineation have largely been restricted to commuting patterns data and approximations. This research examines the emergence of city-regions and their implications for contemporary spatial governance using Ghana as an illustrative case. In the process, inspired by Tobler's first law of geography and the concept of distance decay, the study engages a unique methodological approach that uses spatial mapping of rural-urban population continuum, transportation network, built-up patterns and GIS techniques for the delineation of city-region. The research finds a gap between the rapidly emerging spatial structure of Accra and the operational governance framework, as there is no provision in the latter for the planning and management of the evolving city-region which, territorially, spans multiple administrative regions. At the local context, while making the lagging spatial governance system more responsive to the dynamically evolving spatial structure, it is imperative that urban policy recognises city-regions, such as the Accra City Region (ACR), and their diverse opportunities; plan for them through joint development planning boards; and foster natural coordination even among local planning authorities across different administrative regions. At the global scale, the research practically illustrates that alternative methodologies based on spatial mapping and GIS techniques could provide useful insights into the study of city-regions.