For the first time in history, more than half the world’s population live in cities. However, an estimated one third of all urban residents are poor. Almost half of the poor urban residents in developing countries are children and adolescents. These children are disproportionately affected by the many hazards and deprivations such as limited access to adequate health care. Their access to both preventive and curative health services is often entangled with numerous barriers. This paper uses five dimensions of access—availability, affordability, accommodation, accessibility and acceptability to qualitatively appreciate the access to health care among street children in Kumasi in Ghana. Issues relating to affordability and accommodation presented the most challenges to the children with regards to their access to health care. These dimensions also had greater influence on their choices and preferences with respect to factors relating to other dimensions of access. The paper posits that, urban poor consist of a heterogeneous group of people whose health needs; response to health problems and relationship with the different dimensions of access differ. Hence, attention should be given to the peculiar health needs of poor individuals and groups within urban settings through regular mapping and micro-planning schemes. Moreover, there is an urgent need to improve the health status of urban poor means by improving not only their singular access to health care but also their access to healthy life conditions.