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Water law in most developing countries is shaped by a combination of global and local influences that have taken place throughout the centuries. This article examines the evolution of water law in Ghana from pre-colonial through colonial to current times. It discusses the issues of legal pluralism and how the dynamics of internal law making are influenced by colonial practices and, in the post-colonial era, through aid agencies and international agreements. In this evolutionary history, it focuses in particular on how access to water and sanitation services has been arranged. As can be seen, Ghana has taken a pragmatic approach, prioritizing the issue but not going so far as to recognize a right to water. Instead, it has adopted cost-recovery as an integral part of the integrated water resources management approach. A critical question for the future will be how Ghana reconciles the global adoption of the right to water and sanitation in 2010, and its political acceptance of this right at the UN General Assembly, with its domestic policy making and implementation process.