Despite growing global attention to land use and land cover change (LULCC), limited research integrates high-resolution spatio-temporal data with local socio-ecological insights in rapidly urbanizing yet environmentally vulnerable coastal municipalities such as Ghana's Effutu Municipality. This study addresses this gap by combining Landsat-derived LULCC analysis between 2000 and 2023 with in-depth qualitative field data to examine the drivers of LULCC and their linked ecological and livelihood implications. Spatial analysis reveals a marked decline in forest and grassland cover from 98.29 km2 to 33.53 km2 and 405.59 km2 to 95.64 km2, respectively. This is accompanied by sharp increases in bare land (19.56 km2 to 124.02 km2), built-up areas (63.20 km2 to 175.33 km2), and water bodies (60.76 km2 to 83.30 km2). Field data attribute these shifts primarily to unregulated sand winning and quarrying, population-driven horizontal housing expansion, and agricultural land use pressure. The ecological consequences include land degradation, reduced rainfall, elevated temperatures, and declining soil fertility, threatening both ecosystem stability and agricultural livelihoods. Socio-economically, traditional livelihoods are eroded even as short-term employment in extractive sectors rises. Policy recommendations include enforcing mining regulations with community oversight, promoting vertical housing to reduce land pressure, and investing in clean energy and alternative construction materials to ease forest dependence. Future research should explore causal links between LULCC and localized climate trends, using multi-scalar climate and land use data to further inform integrated planning for climate resilience and sustainable development in similar contexts.