Cocoa in West Africa faces mounting risks from climate change and variability. Research on farmers’ perceptions, adaptation strategies, climate-smart agriculture (CSA) practices, and observed climatic trends (rainfall, temperature) is dispersed, with limited integration and inconsistent metrics. This review will collate, appraise, and synthesize the evidence; evaluate whether farmers’ perceptions align with empirical climate data (with a Ghana focus); and identify actionable gaps for policy supporting climate-resilient cocoa systems.