Small-scale gold mining is an important component of the Ghanaian economy but it has also caused enormous damage to local ecosystems. In this paper, an emergy analysis was conducted in Ghana to assess the environmental performance and the relative sustainability of two artisanal and small-scale gold production systems: alluvial “dig and wash” and underground “ghetto” mines. Results show that both production systems have high environmental impacts, as indicated by an environmental loading ratio (ELR) of 4.31 and environmental sustainability index (ESI) of 0.33 for the alluvial system and 2.53 and 0.52 for the underground system, respectively. Concerning the international trade balance, the emergy exchange ratios of the two systems are both lower than one, at, 0.23 and 0.33 for the alluvial and underground systems, respectively, indicating a significant amount of resource loss to foreign regions. This study could assist in the regulation of the small-scale mining sector bearing in mind the unsustainable nature of their activities. In addition, supporting miners to consider land rehabilitation ethics is urgently needed.