Cocoa, a major source of livelihood for smallholder farmers in Ghana, is produced using conventional practices. Conventional cocoa production depends on high energy and input use. Organic practices were introduced in the late 1990s as an environmentally friendly option that depends on low external input use. Organic cocoa production has the potential to contribute profitability increases through premiums from higher added value. The full potential of organic agriculture and its suitability as a future solution to key agricultural challenges is still not adequately recognised. The study addresses three objectives: (1) comparison of the sustainability performance of organic with conventional cocoa farming system in terms of environmental integrity, economic resilience, social wellbeing, and good governance, (2) identification of trade-offs and synergies within and among the sustainability dimensions of the two farming systems, and (3) the impact of organic and conventional cocoa practices on environmental efficiency. The Sustainability Monitoring and Assessment Routine (SMART-farm tool) and Mann-Whitney U test used to test the mean rank differences between environmental integrity, economic resilience, social well-being, and good governance of the two farming systems. Using the principal component analysis (PCA) method, trade-offs, and synergies between thirty (30) sub-themes of environmental integrity and social wellbeing were identified. The publicly available specification (PAS) and Intergovernmental Panel on Climate Change (IPCC) method were used to determine the impact of organic and conventional cocoa practices on environmental efficiency, using GHGs emissions. The 2017 Organic Farm Systems for Africa (OFSA) database was used to compare the sustainability performance, as well as the identification of trade-offs and synergies between environmental integrity and social wellbeing of two cocoa farming systems in Atwima Mponua District. The 2015-2017 ProEco Africa database was used to determine the impact of organic and conventional cocoa practices on environmental efficiency. In comparing the sustainability performance of organic with conventional cocoa farming systems, the study found the organic farming system to perform better in terms of land degradation, greenhouse gases, profitability, gender equity, and full cost accounting, compared to the conventional. Of the possible pairs among the sustainability dimensions, 52 sub themes were positive and strongly correlated (p < 0.05) for organic farming system suggesting synergies; whiles 32 (30 positive and 2 negative) and were strongly correlated (p < 0.05) for the conventional farming system. The study found more synergies within and among the sustainability dimensions for the organic cocoa farming system compared to conventional. Organic cocoa production (13.29 kg CO2 eq per kg) is environmentally efficient compared to conventional (17.67 kg CO2 eq per kg). There is a need for improvement in the sustainability performance of cocoa farming systems by Cocoa Health and Extension Division (CHED), Tano Biakoye organic cooperative and the department of agriculture. Conserving biodiversity should be prioritise by conventional farmers and they should be encouraged to use indigenous knowledge in the planning and implementation of cocoa sustainability programmes or projects.

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