Background: Open defecation is the disposal of human feces in fields, forests, bushes, open water bodies, beaches or other open spaces. The percentage of people without access to basic sanitation facilities in Africa was 44 percent in 2000 and 37 percent in 2010. Also, 70 percent, or two out of three people, do not have access to a toilet, a staggering statistics couple with the fact that slum growth and urbanization is raising present a difficult situation. A common solution is to share toilet facilities through partnerships of landlord and tenants. However shared sanitation in the form of public or community latrines is a pragmatic way of increasing coverage. This study seeks to examine factors associated with open defecation as well as the beliefs and perceptions towards open defecation. Method: A cross-sectional study using quantitative approach to collect data from participants in Teshie Ledzokuku Municipality from 18years and above. Random sampling was used to choose four (4) electoral names from the total list of 11 (West Akromadeokpo, East Akromadeokpo, Nii Ashitey Akomfra, Okesekor, Aborle-Bu, Sutsurunor, Agblesan, Tsuibleoo South, Tsuibleoo Central, Tsuibleoo North, South Teshie Nuagua Estate, North Nuagua Estate). Furthermore STATA 14 (Statacorp LP, College Station, TX, USA) software was used to analyze the data. Ethical approval was sort from Ensign College of Public Health Ethical Review committee and Ghana Health service. A written consent form was filled by each participant before beginning any questioning. Result: There are three hundred (300) participants. 63% of participant were 18-30years, 97% had some form education, 73% are either employed or self-employed, 41% live in household with less than 5 member and 77% have toilet facilities. The study found that open defecation is practices by both those with toilet facilities (14%) and those without toilet (47%). Major reasons for open defecation are lack of toilet facilities, poverty and the preference to openly defecate.