Members of the pharmaceutical supply chain have various global regulatory requirements to meet while handling, storing and distributing environmentally sensitive products. The focus of the regulatory requirements is to provide cold chain management for temperature sensitive pharmaceuticals to ensure that the quality and efficacy of the product are not compromised along the supply chain. Many countries such as Canada, United Kingdom, South Africa, etc, have issued regulations and specific guidelines that address product integrity during the entire supply chain. It will therefore be of importance to identify how Ghana has developed its cold chain supply systems and how it is able to maintain cold chain for temperature-sensitive medicines considering the challenges of; unreliable electricity supply, inadequate storage facilities, weak validation systems, perceived poor monitoring of cold chain supply management by regulatory authorities. The study was conducted to establish the challenges in the supply chain management of cold chain medicines in the Greater Accra Region and their impact on product quality and public health and safety. The methodology that was used in collecting the research data was descriptive survey where questionnaires were personally administered and visual observation made to corroborate practices, processes and procedures. Purposive sampling was used to identify cold storage facilities that stock cold chain medicines to meet the objectives of the research. The results indicated absence of quality management system, poor contingency for power outages, weak validation of cold storage facilities and qualification of cold chain vans and carriers for transport of cold chain medicines along the supply chain which obviously will impact negatively on product quality, efficacy and potency and finally putting public health and safety at risk. The way forward is effective regulatory oversight responsibilities to ensure compliance to cold chain management standards to protect public health and safety.