<p>Artisanal small-scale gold mining (ASGM) has emerged as both an economic lifeline and an environmental challenge in the Tarkwa Nsuaem District of Ghana, a region renowned for its mineral wealth. This study examines the socio-environmental impacts of ASGM using a mixed-methods approach that integrates quantitative surveys, remote sensing, and Geographic Information Systems (GIS) analysis to provide a comprehensive understanding of the phenomenon. The findings reveal a dual narrative: while ASGM engages 48.5% of the local workforce and serves as a critical source of income, it has also precipitated severe environmental degradation and social disruption. Over the past decade (2013–2023), statistical analysis indicates a 13.58% annual decline in vegetation cover, accompanied by a 301.18% annual increase in urban expansion, driven largely by the proliferation of mining activities. This rapid land-use transformation has resulted in widespread water pollution, soil erosion, and habitat destruction, with over 90% of surveyed residents acknowledging the severe ecological consequences. Social impacts are equally pronounced, including rising living costs, bad health conditions, and increasing school dropout rates. The study further identifies weak regulatory frameworks and governance challenges as key enablers of illegal mining practices. Despite its economic significance, 76.5% of respondents advocate for stricter controls or an outright ban on unregulated mining, emphasizing the need for sustainable practices. The study calls for a multifaceted policy approach, including enhanced regulatory enforcement, reforestation efforts, alternative livelihoods, and community engagement to address the adverse effects of ASGM. The research offers actionable recommendations for policymakers to achieve sustainable development in mining-dependent communities by balancing economic benefits with environmental and social sustainability.</p>