The study evaluates the extent to which Sinapi Aba Trust (SAT) of Ghana, the largest NGO microfinance provider and a key player in the development of the SME sector in the country, has contributed to poverty reduction among rural and urban poor, especially women by supporting them with small loans to generate income to build up their asset base. Since the poor are known not to be homogenous, this study also investigates the type of people that are being served by SAT: whether they are the very poor, the moderately poor or the less poor. The study adapted the DFID's sustainable livelihood framework and used multivariate analysis to evaluate the effect of the programme on participants in terms of asset-building. The main findings of the study are two-fold. First, by comparing the living standards of 231 new clients of SAT with those of 305 non-clients and using the poverty assessment tool developed by Henry et al. (2003), the study found that SAT reaches a disproportionately smaller percentage of the very poor and a higher percentage of the less poor in its operational areas. The study noted that programme placement plays a key role in determining the type of clients reached by SAT since almost all its branches are located in urban centres. This finding implies that unless sufficient investments are made by government and development partners to improve the infrastructural base of such areas, the majority of the very poor will remain outside the reach of microfinance providers. It was found that the objective of financial sustainability being pursued by SAT has eventually caused it to shift the provision of financial services from very poor households to the less poor. Secondly, using cross-sectional data from 547 respondents, made up of 316 established clients and 231 new clients of SAT, the study found that participation in the programme has enabled established clients to build up savings deposits and subscribe to a client welfare scheme which serves as insurance to pay off debts in times of critical illness or death. Participants were also found to be in better position to contribute towards the education of their children and the health care of members of their households and also contribute towards the purchase of household durables. It is observed from the study that programmes that are financially sustainable have greater effects on participants implying that there must be non-interference by governments in the determination of interest rates charged by MFIs. It is further noted that clients who remain in MFI programmes for long periods of time suffer from diminishing marginal returns and there should be some form of up-scaling to accommodate these clients or should be able to join other financial service providers in the formal sector in order to benefit fully from participation in microfinance programmes.