Background: Information about orofacial cysts from African populations is scarce and there are only a few studies available regarding the prevalence of these lesions in the West African sub-region. The purpose of the present study is to determine the distribution and prevalence of all histologically diagnosed orofacial cysts in Kumasi, Ghana. Aim: To determine prevalence, sex, age and anatomic distribution of orofacial cyst seen at the oral and maxillofacial unit in Komfo Anokye Teaching hospital (KATH). Method: This is a retrospective study, which examined histologically diagnosed lesions including orofacial cysts. The study duration was from 1999 to 2010 September inclusive. Results: There were 37 odontogenic cysts constuting 6.5%, of all orofacial lesions. There were 18 non-odontogenic cysts i.e. 3.1% of all lesions diagnosed during the study period. The odontogenic cysts comprised 19 (51.4%) developmental cysts and 18 (48.6%) inflammatory cysts. Male-to-female ratio for the orofacial cysts was 1:1 and the mean age was 36.7 years. Conclusion: There is low prevalence of the odontogenic cysts, which is consistent with findings from other African studies. Although radicular cysts accounted for the majority of orofacial cysts in this study, the prevalence of radicular cysts is low compared to reports from developed countries.