Ghana's economic development relies largely on the mining industry, but the ecological cost is very high, particularly for the small-scale sector. To ascertain and give an account of the ecological pressures from the small-scale gold mining sector, we quantified and appraised the ecosystems (land cover types) degradation due to mining land use along portions of the renowned Pra River basin of Ghana. The study classified and analysed high-quality Landsat image data to monitor processes and changes in the river basin and adopted the Ecosystem Service Value (ESV) model to quantify the forgone value in monetary term. The results revealed that the initial ESV of 17.69 million US$ in 1986 increased to 18.40 million US$ in 2002 for the study landscape with the small-scale mining sector accounting for 8.4% of the trade-off costs. The expansion of forest areas and its higher value coefficient (VC) was, however, prevalent and this resulted in a net positive change during this period. However, in 2016, out of the total ESV of 14.63 million US$ obtained, the small-scale mining activities accounted for 36.8% of the trade-off costs. The substantial increase in trade-off costs with a subsequent decrease in ESV in the study landscape, following the intensification of small-scale gold mining, indicates that their activities have been degrading the watershed ecosystem and are, therefore, unsustainable. The study affirms the need for policymakers/government to review the laws, particularly on post-mining monitoring schemes to deter illegal miners and support the registered small-scale miners who are willing to implement land rehabilitation activities.