Background: Unsafe abortion accounts for a significant proportion of maternal and reproductive health related mortalities and complications in developing countries. In Ghana and sub-Saharan Africa in general, abortion remains a significant barrier to achieving the health related MDGs. Yet, there exist a dearth of information on the determinants of abortion decisions among adolescents, students and other populations at risk. Objectives: This study explores the factors that are likely to influence abortion decisions among University students in Ghana. It also explores their knowledge and perceptions on abortion. Methods: Data were collected from 142 randomly sampled students of the University of Ghana through focus group discussions. Questions focused on their knowledge on abortion and the key determinants of their decisions to abort. The results were recorded, transcribed, and analysed qualitatively using the thematic analysis approach. Results: The students were knowledgeable on abortion. In making decisions on abortion, the students considered their education, religious beliefs, health, economic factors, and family. Conclusions: Factors such as societal pressure and peer influence that, to date, have been the backbone of sexual and reproductive health, anti-abortion stigma, and unsafe abortion education and interventions have minimal influence on abortion decisions among the students. Rather, these interventions must focus on their education, religious beliefs, health, economic factors, and family to make maximum impact.