BACKGROUND: Nosocomial or hospital acquired infection has been recognized as a serious public health problem in the last twenty years. In most hospitals in Africa-South of the Sahara, although the types of community acquired infections are known, neither the magnitude, nor the common types of nosocomial infections has been documented. OBJECTIVE: This study was carried out to find the prevalence of hospital and community acquired infections in hospitals, and to estimate the overall prevalence of HAI and CAI in Korle Bu Teaching Hospital. METHODS: A one-day prevalence survey of nosocomial and community acquired infection in a tertiary-care hospital in Accra was performed using the 1980 British national protocol and the result was analyzed using computerized gargets. RESULTS: Of the 907 patients on admission (on the day of the study), 61 (6.7%) had hospital-acquired infection and 287 (31.6%) had community acquired infection. The commonest hospital acquired infection was wound infection followed by skin and lower respiratory infections. Of the community infections, the most common cases were lower respiratory and skin infections. Fifty-three percent of all patients were on antimicrobial treatment. Patients on metronidazole were 212 (44%), ampicillin/amoxicillin 199 (41.6%), cloxacillin 163 (34%) and gentamicin 135 (28%). Approximately 20% of patients were on three or more drugs. CONCLUSION: This study has shown that the prevalence of community acquired infections in our hospital is much higher than that from nosocomial infections and that the British national survey protocol can be used in countries with limited resources. WAJM 2009; 28(5): 300–303.