Gender-specific perceptions and needs are critical to better understanding climate change adaptation capacities of local smallholder communities in Africa and elsewhere. As many rural agricultural practices are heavily impacted by male-centered traditional customs and mores, gender dimensions can determine the level of success for policy interventions. To better understand how and what gender dimensions can be important factors for farmer’s climate change adaptations, this study attempts to examine smallholder farmers’ adaptation needs and perspectives in Ghana’s Upper East Region. A focus group discussion and a questionnaire survey were conducted among 200 smallholder farmers. We found that the female respondents, who mostly belonged to low/middle-income groups, emphasized their urgent need for financial support to improve their income. They needed more farmland as 94% of them had only less than 5 acres to farm. In addition, 91% of the female respondents expressed the importance of being connected to farmers’ mutual-help groups to share information about common farming needs. We also found gender-specific needs for extension services, farm inputs, climate information, mechanization, and infrastructure. Regarding access to resources, the women respondents had little interest in investing more in farming as the land they borrowed could be taken away by male owners. The study recommends the need for gender-specific support initiatives that prioritize social protection and gender equality.