The effects of three shade densities, NPK fertilizers and fertilizer-pest/disease relationship on Amazon cocoa (Theobroma cacao L.) over a 20-year period are reported. Yields equivalent to the mean yield from the unfertilized plots were achieved in about 3, 4 and 6 years in fertilized plots under the no shade (S0), medium shade (S1) and heavy shade (S2) treatment, respectively. There were three growth phases, each characterized by a different yield trend. No appreciable changes in the exchangeable Ca and Mg were observed during the experiments, but K dropped to 68% of its initial value while the available P of the unfertilized and the S0 plots fell by 38%. Fertilizer recommendation for P and K should take account of overhead shade. The effect of N application was often negative. No direct relationship was observed between fertilizer treatment and the incidence of pest/blackpod/swollen shoot virus (SSV) disease of cocoa. SSV infection was greater under S0. Cocoa farms in Ghana cannot maintain high yields (above 1000 kg dry cocoa ha-1) beyond 15 years of intensive cropping.