The surge in artisanal and small-scale gold mining (ASGM) has led to negative environmental outcomes particularly due to the widespread use of mercury. We use a unique sample of 387 mining-site and non-mining site respondents in eight mining districts in Ghana to understand mining communities’ views on the local opportunities and risks that ASGM brings – with a particular focus on mercury use and other environmental issues – as well as on the recently lifted nationwide ban on ASGM. We find that local communities have a favorable view overall of the local impact of ASGM, but negative effects are also identified, with environmental problems being prevalent and ASGM seen as the main cause of environmental issues — even by the miners themselves. Mining-site respondents did not support the ban on average, while residents from nearby settlements supported it. Knowledge about mercury use and its dangers was mixed, yet self-declared exposure to mercury was widespread throughout ASGM communities. Our findings suggest that any ASGM policy will have to address not only the negative externalities of the sector on local communities, but also take into account its positive local development contributions.