Decentralization has been widely implemented throughout the developing world. Its proponents, notably international donor agencies, claim that democratic local government is more responsive to local citizens' needs, inclusive of those of the majority poor, thus resulting in poverty reduction. Yet evidence remains far from conclusive and this paper challenges such claims. After reviewing recent surveys of the linkage between decentralization and poverty reduction, this paper undertakes a case study of Ghana. Findings from primary data indicate that the impact of the District Assembly system on local poverty has been limited, at best. In seeking to explain such limits to poverty reduction, attention is focused on the national context of decentralization where structural constraints are identified, which are largely intended to maintain central government control. Such obstacles challenge some of the assumptions and expectations of decentralization advocates. It is concluded that the notion of “decentralization from above” is paradoxical, with genuine devolution of power and local poverty reduction likely to require political struggles from below.