Purpose - Although the largest proportion of the household budget is spent on housing and transportation (H+T), housing affordability estimates in Ghana have over the years treated housing as a mutually exclusive expenditure, thereby excluding the effects of transportation costs. This can result in under-reporting of the household burden, which ultimately affects planning and policymaking. To curtail under-reporting, the H+T affordability index incorporates transportation costs into the assessment of housing affordability. However, the H+T affordability index is yet to be explored in the real estate literature from Ghana. This study contributes a novel discussion of the H+T affordability index and how it can be applied in Ghana. Approach - Based on a systematic review of 9 peer-reviewed papers on the H+T affordability index, the main variables employed, the lessons, and policy implications have been discussed towards having a modified H+T affordability index that is suitable for Ghana. Findings - Generally, the addition of transportation costs to the housing burden significantly changes the dynamics of the housing burden. Besides, the H+T Affordability Index relies on accessible secondary H+T economic data. In cities where there is a low proportion of renters, the owners' equivalent rent is used as the rental value. The main variables and methodologies employed in past studies have been discussed. Research implications - Our research calls for researchers and real estate professionals in Ghana to consider developing robust housing, trip, spatial, and neighborhood databases to foster future H+T studies. Practical implications - This study contributes insights that can enhance debates on the H+T affordability index toward improved measurement tools for the household burden in Ghana. Originality/Value of work - This study is the first attempt to discuss how the H+T affordability index can be applied in Ghana's housing market.