Ghana’s agricultural sector has two faces. On the one hand, Ghana continues to face food security problems due to stagnating productivity in the food crop sector and undeveloped internal food markets. On the other hand, horticultural exports have been increasing and recent investments in cocoa and pineapple processing can been seen as signs of an emerging modern agricultural sector. The horticultural sector currently receives a lot of attention from donors and the Ghanaian government. The examination of several large donor projects in this sector reveals that donors are increasingly taking a value chain approach and trying to link smallholder farmers to exporters via outgrower schemes. Donors are also making an effort to connect their projects with other ongoing interventions. However, donor approaches vary according to donor preferences, and multi-donor programmes would probably be a better solution. While the current focus of donors and the Ghanaian government in the horticultural sector is welcome, it bears the risk of leaving the north of Ghana, where food crop production and poverty are concentrated, further behind. Food crops should receive more attention not only to resolve Ghana’s food security problem but also to take advantage of growing demand from Ghana’s middle-income class, which provides the opportunity for developing a local food industry.