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In Ghana, abortion-related mortality is considered a major public health issue that needs to be addressed. Midwives have been trained to safely and effectively provide post-abortion care in the country, yet the expected decline in maternal deaths from abortion complications especially in the rural settings is yet to be realized. Primary Healthcare (PHC) facility is the first point of contact for the rural populace, yet there is minimal evidence on the capacity of midwives serving there to provide post-abortion care. This study assessed the knowledge and practice of post abortion care among midwives in selected primary healthcare (PHC) facilities in Ashanti region of Ghana. A cross sectional descriptive survey design was utilized for the study, and a multi-staged sampling technique was used to select 16 PHCs comprising both government (11) and private (5) owned, from which 112 participants were recruited. A pre-tested structured, self-developed questionnaire was employed to obtain information from the study participants. Obtained data were analyzed using SPSS version 21. A total of 109 questionnaires were accurately completed out of 112 administered, giving a response rate of 97.3%. The midwives’ knowledge of post abortion care (PAC) was mainly in the areas of PAC as treatment for abortion complications 49(36%), while knowledge on the other PAC components was low. Only 63(58%) of the respondents had training on PAC, which was basically on the use of Manual Vacuum Aspiration (MVA) to complete incomplete abortion 52(41%). Among the 70(64%) respondents who indicated that their PHC facilities provide PAC services, only 72(66%) of them actually carried out post abortion care. Reasons advanced by the other 39(36%) who never carried out PAC were lack of; confidence 30(815), skills 27(73%), and knowledge 20(54%). The study recommended the training of midwives serving in PHCs in all components of post-abortion care as a feasible strategy for decentralizing PAC services and reaching out to the neglected rural populace. This aspect of reproductive health need to be re-emphasized in midwifery training curricula, buttress with regular mandatory continuing professional development in the area to improve skills.