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Health literacy has pushed the frontiers of self-care in recent decades, particularly among older adults. However, not much is known about self-medication for minor ailments and chronic conditions among older adults in developing countries. This paper addresses this knowledge gap by examining the prevalence, patterns, and associated factors of self-medication among older adults (aged 50 years and more) in Ghana. The study employed a cross-sectional survey within four communities in the Bosomtwe District, Ghana. Using the purposive, snowballing, and convenient techniques, 384 older adults were involved in the study. Multivariate logistic regressions were used to estimate the factors associated with self-medication. Up to 54.4% of the respondents had self-medicated at least 3 months before the survey, while 60.2% self-medicated at least once every month. Open markets (43%) were the dominant drug sources, while quick relief (26.6%) and cheap cost (22.7%) were the reasons for self-medication. Females (AOR: 2.626, CI: 0.015-0.030, p = 0.022), tertiary graduates (AOR: 1.825, CI: 0.007-0.045, p = 0.045) and uninsured older adults (AOR: 3.293, CI: 0.015-0.026, p = 0.007) were more likely to self-medicate. Furthermore, those with no past illness (AOR: 0.036, CI: 0.007-0.033, p = 0.013) and without non-communicable disease (AOR: 0.008, CI: 0.001-0.012, p = 0.020) were less likely to self-medicate. Policy recommendations targeting the educated, uninsured, female older adults as well as stiffening the sale of medicines without prescription will be necessary for reducing the prevalence of self-medication among older adults. Subjects: Health & Development; Aging; Aging and Health; Health Education and Promotion [ABSTRACT FROM AUTHOR]