The Ghanaian banking industry has undergone considerable transformation since 1988 as a result of the implementation of financial reforms undertaken as part of the structural economic adjustment and stabilisation programme launched in 1983 with the assistance of the International Monetary Fund and World Bank. This study investigates the level of bank efficiency and the degree of bank competition and their determinants in Ghana. In addition, the study also examines the causal relationship between bank efficiency and competition. This is the first comprehensive study on Ghana's banking industry since the financial reforms. Bank competition and efficiency are vital for economic development.