This article describes and explains the impact of the donor-driven Poverty Reduction Strategy Paper (PRSP) and the aid modalities surrounding it in Ghana. It focuses on the period in which the New Patriotic Party (NPP) government was in power from 2001 until 2008, but places this within the broader context of aid dependence in Ghana since the 1980s. It is argued that the PRSP documents produced by the government had little impact on implementing policy actions, but rather their function was to secure debt relief and the continuation of foreign aid from official donors. The article examines what was actually implemented during the NPP government and the factors that influenced those actions. More generally it highlights the constraints Ghanaian governments have faced in pursuing economic transformation within contemporary domestic and international contexts.