Cape Saint Paul Wilt Disease (CSPWD) is a devastating phytoplasma-associated infection that severely impacts coconut trees in Ghana, threatening the livelihoods of coconut farmers, and impacting the country's economy. Factors contributing to the spread and severity of CSPWD, including insect vector population, dynamic population of the associated phytoplasma, environmental conditions, coconut cultivation practices, and host resistance, are discussed. The economic and social impacts of CSPWD, such as reduced coconut production and yield losses are reviewed. Research efforts and management strategies for CSPWD are examined, including diagnostic techniques for detection and monitoring, as well as integrated disease management approaches and sustainability of coconut cultivation in Ghana. The review emphasizes the importance of collaborative research initiatives and capacity building to enhance understanding and control of CSPWD. The significance of adopting sustainable coconut cultivation practices to mitigate the impact of CSPWD and ensure the long-term viability of the coconut industry in Ghana was discussed. The review also provides an overview of the challenges posed by CSPWD and offers a foundation for future research and collaboration. •Cape Saint Paul Wilt disease (CSPWD) is a devasting disease of coconut in Ghana.•Research on CSPWD distribution and detection has been in focus.•An integrated disease management is proposed for sustainable CSPWD control.