In recent years there has been a dominant migration stream from north to south in Ghana of female youths, moving independently of their families, and mainly towards the cities of Accra and Kumasi. Young girls from rural areas, particularly the northern regions move to markets in urban centres to serve as kayayei, female porters, who carry goods on their heads for a negotiated fee. Away from support from their home communities and families, most end up living and working under very poor conditions and are exposed to both physical and reproductive health risks. The paper examines the characteristics of young female migrants working as head load porters (kayayei) in three markets in Accra and their livelihood strategies as they move into the wage market. It also examines the processes through which migration is used to address livelihood needs through an analysis of the intersecting social relations of gender, poverty and vulnerability. It discusses the survival strategies used to overcome poverty and to deal with issues of risk and vulnerability, especially in respect of their reproductive and health rights. The implications for migration policies and poverty reduction strategies are discussed.