The study examined what constitutes traditional guidance and counselling among the Akan ethnic group in Ghana and also explored the theoretical basis for the practice. The study followed a qualitative case study design utilizing interviews to collect data. Using purposive sampling, data was collected from chiefs and queen mothers among the Akan people selected through key informants. Inductive thematic analysis was used to analyze the data. The study revealed that advice giving, prophesies, prescriptions and reinforcements are the practices that constitute traditional guidance and counselling in the observed community. The study also discovered that there is a theoretical underpinning to the practice of traditional guidance and counselling; however, though very functional, its major weakness is that it barely relies on empirical procedures. Based on the latter weakness, the study recommends that seminars and workshops should be organized for practitioners of traditional guidance and counselling to train some of them meeting the level of education but not conversant with how to use some psychometric tools to reliably predict and interpret clients' aptitudes, personalities and interests when need be. Furthermore, the study recommends that to maintain the African philosophy, the people need to go back to their roots to reclaim from their past practices what is wholesome and best, merge it with best western practices and use it to rebuild African guidance and counselling with modernity. This would enable them to render a more satisfying and effective assistance to their clients.