Female Genital Mutilation (FGM) persist despite the numerous global resolutions and recommendations aimed at the elimination of FGM. Despite numerous educational programmes and policies, the practice rather has been persistent in this part of the country. It is in the light of this that this study seeks to examine the social pressures behind FGM and the challenges associated with its eradication in the Upper East Region. The study was carried out in the Bawku East Municipality in the Upper East Region of Ghana. The study found that the perpetrators of FGM are older women, mothers and grandmothers whereas the victims are girls between the ages of 6-18years (Table 5.2). It was also found out that the practice is perpetrated by the elderly (43%; figure 5.8). This is the group that often is referred to as the custodians of culture and/ or tradition. The social pressures also identified are socio-cultural and religious factors within the communities. This study discovered that people become aware of the consequences of the practice of FGM after the victims have submitted themselves to the practice.