Food insecurity and adequate nutrition is a major global challenge, especially in vulnerable groups such as refugee communities. In West Africa, due to conflict and instability in their home country, thousands of Burkina Faso refugees have crossed the border into northern Ghana. We conducted a cross-sectional study aimed at assessing household food insecurity, living conditions, and sense of security among Burkina Faso refugees currently residing in the upper east region of Ghana. Study data was collected from 19-29 October 2022 from 498 refugee households. Results revealed that almost 100% of households experienced food insecurity, with 80.3% experiencing severe food insecurity. Refugees from rural areas were more food secure compared to urban refugees. Refugees residing in host communities experienced lesser food insecurity than those in designated refugee camps. Further, refugees who were dissatisfied with the size of their accommodation were more likely to experience food insecurity. More than half of the refugees felt safe and welcomed by the host communities. The study underscores the critical need for targeted intervention to avert hunger and malnutrition among vulnerable groups such as children, pregnant women, and the aged in the refugee population. The study also emphasizes the importance of community support systems and social amenities for refugees’ well-being. Long-term measures should include improving logistics for food distribution, providing suitable accommodation, and strengthening healthcare services. Follow-up research, such as repeated community surveys, can track this evolving situation to continuously inform decision-making for refugee support.