The study on Female Adolescent Reproductive Change was undertaken as part of the ongoing effort at understanding some of the problems that confront adolescents in Ghana. The study uses a sample of 1,828 female adolescents aged 12-24 years (1,503 from Cape Coast and 325 from Mankrong) in the Central Region of Ghana as a case study. This has the primary purpose of comparing the situation in an urban vis-à-vis a rural area. The general objective of the study is to examine the possible changes in the reproduction among female adolescents within the context of overall fertility decline in Ghana as a way of assessing the progress made in addressing adolescent reproductive health problems following the adoption of a national adolescent reproductive health policy in Ghana. The study examines age at first sex, first marriage, first pregnancy and first birth as a way of finding out any changes that might have occurred in the recent past. It also looks at issues pertaining to pregnancy incidence and wastage as may be related to school attendance. Throughout, comparisons are made with reports from the Ghana Demographic and Health Surveys (GDHS) and other small-scale studies that have been done in certain areas in Ghana. Overall, the study finds that major positive changes have occurred among female adolescents first with respect to the proportion of female adolescents ever having sexual activity. More and more female adolescents continue to abstain from sex. However, among the small proportion that ever indulges in sex, sexual initiation appears to be earlier when age is controlled for