Land Registration in Western and Eastern Regions, Ghana assesses the process of rural land registration in Ghana and its outcomes for poor and marginalised groups. In Ghana, deeds registration has been in place since colonial times, and enables right holders to record their land transactions. However, very little rural land has actually been affected by this registration process. The research shows a general lack of awareness of the registration process among the majority of cash and food crop farmers. High monetary and transaction costs and a long and cumbersome process also constrain use of deeds registration. As a result, while farmers in both Western and Eastern Regions increasingly make use of written documents to secure their transactions, very few bother to register those documents with the deeds registry. On the other hand, deeds registration is commonly used by agribusiness, and by mining and timber companies acquiring interests in land. In other words, while the deeds registration system seems to cater for the needs of medium to large-scale enterprises, it does not respond to the needs of small holders. The ongoing land administration reform programme needs to address these issues in order to establish institutions and processes that secure the land rights of poorer and more vulnerable groups.