The study examined the environmental sanitation and hygienic conditions in Senior High Schools in the Western North Region of Ghana. A cross-sectional survey research design was adopted for the study. A simple random sampling technique was used to select 360 students from three senior high schools. A structured questionnaire was used for data collection. Multiple logistic regression and t-test statistics were used to analyse the data. The study revealed that tap water was the main source of drinking water students (54.4%) used followed by groundwater (22.2%). Also, most students (53.1%) used flush latrine followed by pit latrine (20.0%). Toilets were never covered after use and some too had no lids, as a result, produced offensive odour. Moreover, urinary bays in the schools were untidy and produced offensive odour as well. Stagnant water was found in most schools. A significant proportion of students (83.6%) washed their hands after using toilets with water and soap. However, 1 out of every 16 persons washed their hands with water only. Unwholesome environmental practices such as open dumping and burning were ways schools disposed of their solid waste. The result of the multiple logistic regression showed that there was no statistically significant association between gender and their participation in school sanitation exercise (B= 0.100, Wald test = 0.100, p = 0.752, p > 0.05). The level of environmental sanitation and hygienic conditions in senior high schools in the Western North Region of Ghana was inadequate and needs to be improved. It is recommended that teachers and heads of senior high schools in the Western North Region of Ghana should ensure proper maintenance of toilet facilities and equip students to drain all stagnant water in their schools to improve upon the environmental sanitation and hygienic conditions in the schools.