BACKGROUND: Dyslipidaemia is a major modifiable risk factor for cardiovascular disease and has become an increasing public health concern in sub-Saharan Africa. Rapid urbanisation, dietary transitions, and sedentary lifestyles have contributed to the rising incidence of cardiometabolic diseases in Ghana. However, evidence on the overall burden and patterns of dyslipidaemia in adults remains unclear. This systematic review aimed to synthesise the evidence on the prevalence and lipid profile patterns of adult Ghanaians. METHODS: A comprehensive search of PubMed, Scopus, Web of Science, African Journals Online, Africa-Wide Information and African Index Medicus databases was conducted for studies published between January 1980 and November 2025. Eligible studies reported the prevalence or distribution of dyslipidaemia in Ghanaian adults (≥ 18 years). Two reviewers independently screened, extracted, and assessed the quality of included studies. Findings were synthesised narratively and summarised in descriptive tables and figures, due to heterogeneity in study designs and data reporting. RESULTS: Twenty-four studies published between 2003 and 2023, comprising approximately 11,400 participants, met the inclusion criteria. Across the included studies, the reported prevalence of dyslipidaemia ranged from 3.0% to 72.4%, reflecting differences in study populations, diagnostic criteria and study settings. Low high-density lipoprotein cholesterol (HDL-C) was the most frequent abnormality, followed by elevated total and low-density lipoprotein cholesterol (LDL-C), whereas hypertriglyceridaemia was the least common. Studies from southern and middle regions-particularly Ashanti, Brong-Ahafo, and Greater Accra-reported a higher dyslipidaemia prevalence than those from northern Ghana. Considerable variation in diagnostic criteria, study populations and sampling strategies limited comparability and precluded meta-analysis. CONCLUSION: Dyslipidaemia is common among adult Ghanaians, with low HDL-C emerging as the predominant abnormality. Methodological differences and sampling biases limit the precise estimation of the national burden, but the available evidence indicates a growing cardiometabolic risk. Future studies should prioritise community-based sampling and context-appropriate lipid thresholds to support evidence-based cardiovascular risk-reduction strategies.