Approximately 80% of Ghana’s 550 km-long coastline consists of sandy shores, and coastal erosion has intensified following the construction of major dams. Although numerous erosion control structures have been implemented over the decades, fundamental solutions remain elusive. This study evaluates the effectiveness of such coastal structures using 40 years of optical satellite imagery. To improve the positional accuracy of shoreline data, co-registration was applied using an image matching approach, which reduced horizontal geolocation errors to approximately half the image pixel resolution. A total of 135 transects were analyzed across the entire coastline of Ghana. Between 1984 and 2023, 20.0% of locations exhibited accretion, while 20.8% experienced erosion. Since 2016, the construction of ports and other coastal structures has notably increased, leading to significant alterations in sediment transport patterns. These findings reveal a marked shift in coastal dynamics associated with human intervention. The results highlight the need for continuous coastal monitoring and integrated shoreline management strategies to better address the complex interactions between engineered infrastructure and natural coastal processes.