Guinea fowl farming is vital to the livelihoods of rural communities in northern Ghana, yet its socio-economic and production dynamics remain underexplored, especially concerning health management and climate change. This study bridges this gap by investigating the socio-economic profiles, production practices, and health challenges of guinea fowl farmers in three towns in northern Ghana. A total of 137 farmers participated in structured interviews, with data analyzed using one-way and two-way ANOVA tests in SPSS version 21. The results highlighted variations in farmer demographics, with most being married, involved in crop farming, and having non-formal education. Guinea fowl production served for both sale and home consumption, with adult birds, keets, and young birds priced at > 69, 9–10, and 18–30 Cedis, respectively, while fertile and table eggs cost 4–4.5 Cedis. Flock sizes ranged from 10–60, predominantly of the Lavender breed. Farmers favored semi-intensive systems with traditional poultry shelters, supplemented feed, and pond or river serving as water sources. Disease symptoms, such as wing drooping, and high mortality rates were major challenges, with climate change exacerbating disease prevalence and management costs. These findings highlight the need for enhanced disease management, climate-resilient practices, and targeted interventions to ensure sustainable guinea fowl production and improved livelihoods. © The Author(s) 2025.