The study set out to assess the fish consumption behavior of low-income households residing in urban areas of Greater Accra and Northern regions of Ghana. The study examined the factors influencing household preferences for fish products (fresh, processed fish or both) and also analyzed socio-economic and geographic factors affecting household income allocation decisions. The study employed the multinomial logit model to analyse the factors influencing household preferences for fish products while the Tobit model was used to analyse the determinants of household income allocation to fish purchase. Data was collected from 300 households residing in poor neighbourhoods of Accra and Tamale. The survey revealed that the most widely consumed fish by households include salmon, sardinella, seabream and anchovy. The estimated mean share of household income allocation was approximately 27%. Results from the multinomial logit model indicate that the likelihood of choosing fresh fish and fresh/processed fish alternatives over processed fish increases with households residing in Greater Accra region, Christian households, fish price increase, households taste for smaller fish, larger size households and easy accessibility to local markets. Further, the results from the multinomial model indicate that the probability of choosing fresh fish and fresh/processed fish alternatives over processed fish decreases with an increase in age, marital status, higher education and occupation. The result from the Tobit model show that a cedi increase in fish price, marital status, nearness to local markets and household living in Greater Accra increase the proportion of income households allocate to fish purchase by 2.8%, 20%, 14.1% and 24.6%, respectively. The results further suggest that higher education, increase in income and an increase in household size by one person decrease the share of income households allocate to fish consumption by 8.4%, 0.2% and 1.5%, respectively. It is recommended that Government and the appropriate agencies should intensify education campaigns targeting people with higher or low levels of education about the numerous benefits (e.g health and nutritional) of regular consumption of fish. Preference for processed fish presents an opportunity for research and development of existing fish processing methods and on range of value-added fish products targeting the aged, educated and the working class consumers. Efforts should be made to reduce the distance between landing centers and consumption centers especially in inland areas through the development and/or improvements in transportation and distribution systems to help bring fish close to consumers. Government should strengthen the pre-mix fuel subsidy policy and reduce cost of transportation through development of infrastructure to reduce fish prices and make fish affordable to low-income households. There is the need to enlightened and create awareness about the nutritional value of fish to forestall expenditure cuts on fish. The government should support the development of value chains of smaller fishes such as sardinella and anchovy as they are preferred by households.