Teaching and learning in Ghana's Senior High Schools (SHSs) are guided by a centralized curriculum, teaching syllabus, textbooks, assessment criteria, and examinations, yet rural-urban disparities exist in educational resources provision, which significantly affect teaching and learning processes and student achievement in the SHSs, particularly those on the Visual Arts program. To understand the factors that cause rural-urban differentials in student performance in different SHSs in Ghana, we adopted a qualitative-quantitative research approach with interview, observation, and questionnaire administration to examine teaching and learning of Visual Arts in six public SHSs: two each in rural, peri-urban, and urban settings in metropolitan Kumasi. Findings from data sourced from 120 students (66 males; 54 females), 17 teachers (15 males; two females), and 24 Visual Arts lessons revealed that unlike Visual Arts education in urban SHSs, student achievement in rural and peri-urban schools is hampered by lowered criteria for admitting students into Visual Arts, large class sizes, lack of studio facilities, insufficient specialist teachers, and instructional time for teaching elective Visual Arts subjects, adoption of ineffective teaching strategies, setting of low academic standards, and inadequate funding for teaching practical lessons. Unlike rural and peri-urban SHSs, urban schools organize speech and prize-giving days to motivate students, and effectively collaborate with Visual Arts students to mount art exhibitions to showcase their creativity. Improving the quality and distribution of social infrastructure, educational facilities, and qualified teachers, and actively monitoring educational standards in rural and peri-urban SHSs could raise academic achievement for students in all parts of Ghana.