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Background: Information on the visual health of school children can assist in developing strategies to reduce preventable causes of visual impairment (VI) and maintain good vision.Aim: This study aimed to determine the magnitude and causes of VI amongst basic school children aged 6–16 years in the Bono Region of Ghana.Setting: The study site included five basic schools in 12 administrative districts of the Bono Region of Ghana.Methods: A multistage random sampling technique was used to enrol 645 participants from five selected public schools.Results: Overall, 1.4% of the sample had some form of VI that was worse than mild or no VI, and ocular conditions were present amongst 45.1% of the participants. Uncorrected refractive error (URE) was found amongst 9.8% of the study participants (n = 63) and was an important cause of VI. Other ocular conditions detected in the sample included allergic conjunctivitis (n = 174), cataract (n = 2) and keratoconus (n = 2). Overall, 632 (98.0%) participants recorded a visual acuity (VA) of 20/20 – 20/60, 11 (1.7%) participants had a VA of 20/60 – 20/200, 1 (0.15%) participant had a VA of 20/200 – 10/200 and 1 (0.15%) participant had a VA of 10/200.Conclusion: The presence of ocular conditions was high amongst the study participants (45.1%). However, the prevalence of VI was found to be low (1.4%) with URE being the most common cause. This study supports the need to intensify awareness of ocular conditions and/or VI in basic schools through regular vision health screening and education.