The economy of the Upper West Region of Ghana is largely agrarian with an estimated 86 percent of the population engaged in agricultural production as a source of livelihood. However, agriculture in the region is beset with a single maxima and erratic rainfall pattern which leads to poor yield of crops. This goes to worsen the poverty situation of the people. In order to mitigate the negative impact of this problem, the Government of Ghana and other development partners have provided some irrigation facilities in the region to ensure all-year-round farming activities so as to increase food production. The irrigation facilities are however underutilized. This study therefore set out to find the underlying causes of the underutilization. The study found among other things, the causes of underutilization to be non-adherence to the project planning stages, poor construction works, low technical capacity of agricultural extension agents, and weak management of Water User Associations. Underutilization can be curbed by involving farmers in the irrigation planning process as well as creating an enabling environment for farmers to produce and market their produce.