Background <p>Schistosomiasis is endemic in Ghana, especially in the Volta Region. However, the burden of the disease in the region is not well described. This study described the incidence, trends and distribution of schistosomiasis in the Volta Region to guide control interventions and policy decision-making to eliminate the disease.</p> Methods <p>A descriptive analysis of secondary data was conducted on reported cases of schistosomiasis in all 18 districts in the Volta Region. The data was obtained from the DHIMS-2 database from 2019 to 2023. Frequencies, proportions and incidence rates were computed and the results presented in tables, graphs and maps.</p> Results <p>A total of 834 cases of schistosomiasis sought treatment at health facilities during the five-year period in the Volta Region. The average incidence was 9.7/100,000 population with no reported deaths. Over the five-year period, the incidence rate ranged from 5.9/100,000 in 2020 to 15.7/100,000 in 2023. A higher incidence of cases was observed in males, 69.9/100,000, than in females, 28.6/100,000. The most affected age group was 18–19 years, with 86.1/100,000 population. Cumulatively, Akatsi South recorded the highest incidence, 135.4/100,000, while Anloga recorded the lowest, 3.1/100,000.</p> Conclusion <p>Schistosomiasis incidence in the Volta Region increased during the five-year study period, with males more affected than females. There were geographic variations and the 18–19 age group was most affected. Comprehensive strategies, including surveys to identify all transmission hot spots, continuous monitoring, and scaling up of targeted interventions, are needed to effectively control and eliminate the disease in all geographical areas of the region.</p>