Supported by the Environmental Kuznets Curve Theory (EKCT), charcoal production is an important economic activity for rural communities and a key energy source for urban areas. However, the environmental and health effects are increasingly being questioned. This study explored the socio-economic benefits, environmental impacts, health effects, and community perceptions of charcoal production in the Kintampo area of the Bono East Region using a qualitative approach. The target population comprised approximately 200 residents of Kintampo, including community members, charcoal producers, local authorities and other stakeholders directly or indirectly involved in the charcoal value chain. A stratified purposive sampling technique was used, whereby the population was first stratified by gender and age group before participants were purposively selected within each stratum, yielding a sample of 12 participants, comprising four older women, four men and four youth, for the study. Data collection was done through in-depth interviews and focus group discussions with charcoal producers, farmers, community members and local authorities. Thematic analysis yielded five main themes, namely socio-economic benefits, environmental impacts, awareness of policies and regulations, health and agricultural implications, and community perceptions and attitudes. The results indicate that charcoal production is an important source of income and employment, satisfying household needs and bolstering local trade networks. At the same time, negative impacts such as deforestation, biodiversity loss, soil erosion and reduced agricultural productivity were observed. Health hazards such as lung and eye diseases were frequently mentioned. Although respondents were aware of existing regulations, they identified weak enforcement and a tendency for economic considerations to trump compliance with regulations. The participants expressed a willingness to use alternative sources of energy if they were affordable and easy to access, illustrating the dilemma between economic survival and ecological sustainability. Integrated interventions including improved technologies, livelihood diversification, community education, strengthening of policy enforcement and access to cleaner energy alternatives for sustainable charcoal production in Kintampo are recommended. The findings offer useful insights for policymakers, development agencies and local stakeholders to reconcile rural livelihoods with environmental conservation and public health goals.