Abstract: The study assessed contamination levels of lettuce with helminth parasites and associated practices that may influence contamination levels at farm, market and street food vendor points in urban and peri-urban Kumasi. Three farms, three market sites that sold lettuce purchased from the selected farms and 20 street food vendors, who purchase their lettuce from these markets, were studied. Samples of lettuce, irrigation water and refreshing water (water used for keeping lettuce fresh throughout the day) were collected from these sites and analyzed for helminths eggs/larvae using standard methodology. Helminths on the lettuce leaves, irrigation water and refreshing water in the farms and markets were mostly Ascaris lumbricoides, with some Shistosoma, Hookworm, Trichuris trichura, Taenia, Clonorchis and Strongyloides larvae. Helminths eggs on lettuce leaves ranged between 4 and 14 100-1 g wet weight and 3 and 25 eggs L-1 in irrigation water on the farms and between 2 and 7 100-1 g wet weight and 4 and 15 eggs L-1 in refreshing water in the markets. Helminths egg counts on lettuce leaves on two farms were 40-52.9% more when compared with the farms’ irrigation water but one farm had 40.5% more in irrigation water when compared with the lettuce leaves and these differences were significant. Helminths eggs on lettuce from the two farms were 50 and 60% higher when compared with its corresponding market samples and 23.5% higher in one market when compared with its farm source. Helminths eggs in street food lettuce samples analysed from the selected areas were only Ascaris and Shistosoma eggs ranging between 0 to 2 eggs 100-1 g wet weight. Helminths eggs for both farm and market samples exceeded the recommended level of <1egg L-1. Education on farm practices, post harvest handling and washing methods at both market and street food vendor sites and improved hygienic practices at consumer level may help reduce their numbers and minimize the risk.