Introduction: Involvements of children in physical activities in urban Ghana is declining in walking/cycling to school (CTS). However, these sustainable and active modes have health, psychosocial and environmental benefits. With limited studies on children transport and health from Africa, this study aimed to determine factors associated with school travel modes in the context of Sunyani, Bono, Ghana. Methods: The study adopted a descriptive survey design and multistage sample methods of data collection involving 460 school children aged 9 to 18. Principal component analysis and two multinomial logistic regression models were performed on obtained data. Results: The study found six latent factors influencing active travel to and from school (ATS). Personal, household-level and travel-related characteristics were significant predictors of school mode choice. ATS prevalence was 85% walking and 12% cycling. CTS was prevalent among boys than girls. 12-14-year-olds and secondary school students preferred CTS while 9-11-year-olds favoured motorised transport to school. While walking was more likely, CTS was less likely among middle school students than primary pupils. Household income, parental car and driving license ownership, and educational background were strongly associated with ATS uptake. School distance and public transport accessibility were significantly associated with increased odds of CTS but the odds decreased with increasing access to school bus services. Car ownership increased cycling odds by 5% and decreased the odds of selecting alternative modes by 34% while walking/cycling odds diminished between 24 and 29% as the number of children increased. The likelihood of sedentary modes utilisation for school increased by 129% among children of tertiary-educated parents. Conclusion: Our findings suggest that walking and cycling to and from school are strongly associated with individual, family and trip characteristics of students and underlying six unobserved determinants which could provide support for resuscitating interventions and engineering measures to make travelling actively safe, sustainable and socially inclusive.