Among school children, uncorrected refractive errors have a considerable impact on their participation and learning in class. The aim of this study was to assess the prevalence of refractive error among students in the Ejisu-Juabeng Municipality of Ghana. A survey with multi-stage sampling was undertaken. We interviewed 504 students aged 12-17 years and examined them for refractive errors. The prevalence of refractive errors among those with and without refractive error was compared by means of the chi-square test. Logistic regression analysis using refractive error as the dependent variable and adjusting for risk factors were performed. The overall prevalence rate of refractive errors was 7.5%. Out of the number of children with refractive errors, 39.5% had astigmatism, 31.6% had hyperopia and 28.9% had myopia. The prevalence rate was significantly higher among urban compared with rural students. Astigmatic refractive errors consists of with-the-rule (WTR) astigmatism 66.7%, against-the-rule (ATR) astigmatism 26.7% and oblique astigmatism (OBL) 6.6%. WTR and ATR astigmatism were more common in females than males. Multivariate logistic regression models showed no substantial confounding effects between near work, sex, and residence, suggesting that each covariate has an independent association with refractive error. In conclusion, near work, sex and high parental education level are factors contributing to refractive errors. Children in urban areas are at higher risk compared with their rural counterparts. We suggest that an efficient pre-school vision examination must be made part of the admission policy of all schools in Ghana.