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The recent development of making secondary school education free in Ghana has raised concerns about the level of preparedness of teachers to teach students with diverse needs in one classroom. Significantly, mathematics is one of the core areas that the Ghanaian government has prioritised, and it has institutionalised mechanisms to encourage participation by many students. Accordingly, this qualitative study aimed to document the level of preparedness of mathematics teachers to support the teaching of students with Down syndrome in secondary school classrooms. Twenty-seven mathematics teachers from 14 schools, made up of 18 males and nine females, took part in the study. We found that participants were in favour of implementation of inclusive education. However, regarding the prospect of teaching students with Down syndrome, most of the participants thought that the regular secondary school classroom is not a suitable environment for these students to access education, especially due to a number of challenges. The need for the government to support schools with appropriate teaching materials and facilities is discussed extensively. 2018, 2018 Informa UK Limited, trading as Taylor & Francis Group.