Purpose: Leadership is a key commodity in twenty-first century organizations. This is especially true for school organizations. This paper aims to respond to six questions about head teachers and leadership of basic schools. Design/methodology/approach: Head teachers responded to survey items about proficiencies required for effective leadership and those demonstrated in practice. The Greater Accra region of Ghana was the setting and head teachers constituted the sample. A survey with a unique identifier was distributed to head teachers at their schools. Analysis was conducted using SPSS and output was translated into frequencies and percentages. Findings: A premise of the research was that heads of basic schools lacked leadership proficiencies because of the absence of school leadership preparation programs. Heads of basic schools lack professional preparation in leadership, and practice management and administrative behaviors rather than leadership. Practical implications: Ghana has implemented several reforms with the intent of developing a quality education system; however, there has not been a focus on leadership. The literature is clear about the vital role head teachers have in effective schools and student achievement. This research calls attention to the leadership needs of head teachers in the Ghana education system. Originality/value: This research reveals that Ghana faces a leadership challenge related to head teachers' professional development. The results are an alert to policy makers to institute educational reform that addresses head teachers' leadership in basic schools. (Contains 6 tables.)