Cabbage is an important commercial vegetable in Southern Ghana, where its cultivation serves as a major source of income for smallholder farmers. However, insect pests; particularly aphids cause significant damage and transmit viral diseases to cabbage leading to poor yield and quality. To address these challenges, this study evaluated farmers’ knowledge and perceptions of aphids, their seasonal occurrence, infestation levels, and management practices in Southern Ghana. A survey was conducted among 121 commercial cabbage producers across four major production regions: Ashanti (n = 35), Greater Accra (n = 37), Central (n = 20), and Eastern (n = 29). Farmers had a good knowledge on the seasonal fluctuations of aphid populations, their damage, and the various management practices available. Consequently, they recognized aphids as a major threat to cabbage production. Seven varieties of cabbage were cultivated by farmers; mainly Oxylus, Fortune, KK Cross, Super Cross, Santa, Copenhagen market and Leader Cross, but the majority of farmers (> 80%) cultivated Oxylus variety, which they regarded as ‘farmers’ choice’. Farmers employed a wide range of control measures particularly use of pesticides, sometimes rotating synthetic with biological pesticides, and other times, mixing a cocktail of different pesticides. There were significant relations between respondents having formal education and/or agricultural training with knowledge of pest bio-ecology, adoption of integrated pest management (IPM) practices as well as wearing of protective clothing during insecticide application. These findings synthesize farmers’ baseline knowledge and perceptions, which offer key insights for developing adaptive IPM technologies, and demonstrating an urgent need to transition from total chemical dependence toward bio-based IPM interventions and structured extension training for smallholder vegetable growers in Ghana.