Climate change has the potential to increase food insecurity and exacerbate malnutrition in small-scale farming households through its impacts on crop yield and income. Using a mixed-methods design, a cross-sectional study was carried out in the Bibiani-Anhwiaso Bekwai District in the Western Region of Ghana among 210 farming households with the objective of finding associations between climate change and food and nutrition security in small-scale farming households. Results from the quantitative study showed that 72% of the participants had perceived changes in weather patterns. Majority (94%) of the participants were food insecure and households that had perceived climate change were 11 times more likely to be food insecure than those that had not (p = 0.001). Results from the qualitative study showed that participants had observed less predictable weather patterns which had negative impacts on crop yield, food security and dietary diversity. The study recommended educating and encouraging farmers to adopt climate-smart agricultural practices and other modern technologies to enhance crop production and livelihood of small-scale farmers as well as food and nutrition security within the district.