Abstract Objective The incidence of Buruli ulcer has been recorded in about 30 countries globally and Africa seems to be the most affected area. The study sought to determine perceived causes and risk factors of Buruli ulcer among patients who visit the Agogo hospital in Asante-Akim North District in the Ashanti region of Ghana. A descriptive study design was adopted using a simple random sampling technique to select 400 patients attending The Presbyterian Hospital at Agogo. Data was collected using a structured questionnaire and analysed using SPSS version 16.0. Results Buruli ulcer was perceived as a disease caused by witchcraft (38%), enemies (15%), as well as not pouring libation or praying (16%). Also, increased appetite (30%), oedema or swelling on the skin (29%) and over weight (23%) was perceived as signs and symptoms of Buruli ulcer and a section of the respondents (53%) did not know any risk factor. The age of respondents, gender and level of education were found to determine knowledge of Buruli ulcer (P ⠤ .05). Public Educations and campaigns should focus on causes and risk factors to ensure that there is adequate knowledge among the general public on Buruli ulcer.