Our understanding of how birds use human supplementary resources, especially artificial structures and patchy vegetation within urban areas, is limited. Our study compared the use of artificial structures versus natural vegetation by birds in built-up areas in the Cape Coast Metropolitan Assembly (CCMA) in the central region of Ghana. Using point count technique, we recorded bird species and the activities performed as well as the substrates they use in residential and commercial areas within the CCMA. We found that the mean bird abundance that used artificial structures did not differ significantly from those that used natural vegetation. The mean species richness that used artificial structures was found to differ significantly from those that used natural vegetation. The study also found a significant difference in activities performed by bird species and the substrate type used for daily life activities. Across species, birds showed preference for trees, shrubs, and natural vegetation structures for perching, feeding, and singing, whereas artificial structures such as billboards, telecommunication masts, ceilings of buildings, pylons, buildings, opening in street lights, and windows of buildings were preferred for nesting. These results demonstrate that although not a replacement for natural resources, artificial structures, when combined with natural vegetation, could contribute significantly to the survival of urban birds. Conservation practitioners could encourage urban mosaic landscapes of built and green spaces to conserve and restore populations of birds.