Efforts made to improve the availability and access to family planning services to adolescents in Ghana have not yielded the desired results. Adolescents in the Kintampo Health and Demographic Surveillance System area are no exception. This study explored contraceptive use intentions, preferences and their determinants among adolescents in rural Ghana. This was to contribute evidence towards achieving universal access to reproductive health. A cross-sectional study design was used to collect Sexual and Reproductive Health data in the Kintampo districts in 2011. A total of 1805 female adolescents were randomly sampled from a resident female adolescent population of 16,795. This study used intention and/or willingness of adolescents to use contraceptives as the outcome variable and the explanatory variables were demographic and socio-economic factors. Descriptive and inferential statistical analyses were done. The findings indicated 54.3% of adolescents’ were willing to use contraceptives. Injectable was the most preferred contraceptive method among adolescents (48.6%); this was followed by the pill (29.6%) with the least being foam or jelly (0.2%). The most commonly cited reason for not intending to use contraception was adolescents’ opposition to family planning (31.5%) followed by a fear of side effects (25.8%). Age and education influenced adolescents’ willingness to use contraceptives in the future. Formal education of the young generation coupled with knowledge of contraceptive methods could yield positive outcomes for contraceptive use and ultimately reproductive health of the adolescent population in the near future