In this study, a qualitative research method using Driver Pressure State Impact Response (DPSIR) framework was employed to assess the drivers of environmental degradation and their implications on Anlo and Sanwoma coastal communities in the Western Region of Ghana. Pollution Index (PI) and Environmental Risk Factor (ERF) were estimated in Pra and Ankobra estuaries, respectively, in Anlo and Sanwoma communities to complement the qualitative assessment in the studied coastal communities. The state and condition of the coastal ecosystems are critical to the well-being and livelihood of the residents of the two coastal communities. Therefore, it was important to assess the drivers of environmental degradation and their consequences on the coastal communities. The findings showed that the coastal communities were severely degraded and were in a vulnerable state due to the impact of drivers such as gold mining, farming, improper waste disposal, and illegal fishing that pressurize the environment. Also, PI and ERFs showed that the estuaries in Anlo and Sanwoma coastal communities were contaminated with metals such as arsenic, lead, zinc, and iron. Some of the impacts of the environmental degradation on the communities included reduction in fish catch and health-related ailments among the residents of the two communities. Unfortunately, regulatory policies by government and efforts of non-governmental organisations and members of the two coastal communities to address the environmental issues have not yielded the desired results. It is recommended that there should be urgent interventions by policymakers to stop further degradations in the coastal communities to enhance the well-being and livelihoods of the residents of Anlo and Sanwoma.