Several recent international assessments have concluded that climate change has the potential to reverse the modest economic gains achieved in many developing countries over the past decade. The phenomenon of climate change threatens to worsen poverty or burden populations with additional hardships, especially in poor societies with weak infrastructure and economic well-being. The importance of the perceptions, experiences, and knowledge of indigenous peoples has gained prominence in discussions of climate change and adaptation in developing countries and among international development organizations. Efforts to evaluate the role of indigenous knowledge in adaptation planning, however, have largely focused on rural people and their agricultural livelihoods. This paper presents the results of a study that examines perceptions, experiences, and indigenous knowledge relating to climate change and variability in three communities of metropolitan Accra, which is the capital of Ghana. The study design is based on a three-part conceptual framework and interview process involving risk mapping, mental models, and individual stressor cognition. Most of the residents interviewed in the three communities of urban Accra attributed climate change to the combination of deforestation and the burning of firewood and rubbish. None of the residents associated climate change with fossil fuel emissions from developed countries. Numerous potential adaptation strategies were suggested by the residents, many of which have been used effectively during past drought and flood events. Results suggest that ethnic residential clustering as well as strong community bonds in metropolitan Accra have allowed various groups and long-settled communities to engage in the sharing and transmission of knowledge of weather patterns and trends. Understanding and building upon indigenous knowledge may enhance the design, acceptance, and implementation of climate change adaptation strategies in Accra and urban regions of other developing nations.