Abstract Objective To investigate differences in overweight and obesity between first-generation Dutch-Ghanaian migrants in The Netherlands and their rural and urban counterparts in Ghana. Design Cross-sectional study. Subjects A total of 1471 Ghanaians (rural Ghanaians, n 532; urban Ghanaians, n 787; Dutch-Ghanaians, n 152) aged ≥17 years. Main outcome measures Overweight (BMI ≥ 25 kg/m 2 ) and obesity (BMI ≥ 30 kg/m 2 ). Results Dutch-Ghanaians had a significantly higher prevalence of overweight and obesity (men 69·1 %, women 79·5 %) than urban Ghanaians (men 22·0 %, women 50·0 %) and rural Ghanaians (men 10·3 %, women 19·0 %). Urban Ghanaian men and women also had a significantly higher prevalence of overweight and obesity than their rural Ghanaian counterparts. In a logistic regression analysis adjusting for age and education, the odds ratios for being overweight or obese were 3·10 (95 % CI 1·75, 5·48) for urban Ghanaian men and 19·06 (95 % CI 8·98, 40·43) for Dutch-Ghanaian men compared with rural Ghanaian men. Among women, the odds ratios for being overweight and obese were 3·84 (95 % CI 2·66, 5·53) for urban Ghanaians and 11·4 (95 % CI 5·97, 22·07) for Dutch-Ghanaians compared with their rural Ghanaian counterparts. Conclusion Our current findings give credence to earlier reports of an increase in the prevalence of overweight/obesity with urbanization within Africa and migration to industrialized countries. These findings indicate an urgent need to further assess migration-related factors that lead to these increases in overweight and obesity among migrants with non-Western background, and their impact on overweight- and obesity-related illnesses such as diabetes among these populations.