The Tamale Metropolitan Area (TMA), as a low-income city in a heavily indebted poor country, is at the first stage of the urban environmental transition where most of the environmental problems tend to occur close to the home. Some of the more severe household environmental problems are poor housing, inadequate potable water supply, unsanitary conditions, uncollected garbage, indoor air pollution and pest infestation. Those usually exposed to these environmental burdens are the less wealthy households who have benefited less from development planning and infrastructure provision. Using questionnaire survey and focus group discussions, this study explored the environmental anxieties of households in the metropolis. A stratified sample of residential areas of the city was employed, and the study is able to examine city-wide disparities. The results indicate that problems of water supply are the concern of all groups. Sanitation and garbage disposal services are problems faced mainly by the poor in low-income areas. Other problems faced by the poor are overcrowding, indoor air pollution and pest infestation, but these problems are not highlighted by the poor reflecting a misplaced lack of concern for these problem areas and ignorance of the health risks posed by these hazards. The finding suggests a considerable demand for improvements in environmental service provision and a general willingness to pay for such improvements.