Female genital mutilation (FGM) has long been practised in many communities in the Upper East Region of Ghana. Although the Ghanaian state has a long tradition of supporting women's rights, it has not been successful in eradicating FGM, despite a law against the practice in an amendment to the Criminal Code in 1994 and the Domestic Violence Act 2003. This qualitative study in the Upper East Region examined the role of the state in stopping the practice of FGM through legal means, and why FGM continues to be practised in the community. In-depth interviews were conducted with six state officials, a circumciser, the president of a women's advocacy organisation, and semi-structured interviews with 32 community members. Although FGM has been criminalised, political support to ensure that the law is effectively implemented has been lacking. FGM education and eradication must be given more priority and significant funding by the Ghanaian state. For interventions to be effective, legal measures need to be combined with social measures. Communities practising FGM must be involved in the planning and implementation of anti-FGM interventions. Successful eradication of the practice is possible if education and dialogue between state institutions, gender and human rights groups and practising communities is strengthened.