How did living standards in Ghana develop in the long run? The obvious constraint for a long-term perspective is the limited amount of good data and a consistent measure of human well-being. This is especially the case for the period of colonial rule. Using anthropometric techniques we explore the evolution of living standards and regional inequality in Ghana from 1880 to 2000. Ghana provides an extremely interesting case study. Major economic and social changes took place in the late nineteenth and early twentieth centuries. The development of the agricultural export economy, already under way since the decline of the Atlantic slave trade, was consolidated by the adoption of cocoa, of which Ghana became the world’s leading producer. Cocoa farms, and European-owned mines, eventually attracted extensive migrant labour. Railways and lorries revolutionised transport. Medical knowledge spread. Our findings suggest that, overall, living standards improved during colonial times and that a trend reversal only occurred after the economic crisis in the 1970s. This fact is challenging prominent explanations of colonial legacy and allows insights into the institutional argument for growth.