To date the management of state-maintained special schools for children with hearing impairment (SMSSCHI) in Ghana has not been extensively researched. As a result, the way such schools are managed is inadequately understood. This research sought to address that lack of understanding. The aim of the research was to examine the nature of the day-to-day management activities in SMSSCHI to refine our current understanding of such schools. Research questions focused on the nature of the day-to-day management; the organisational challenges; the relationships between the SMSSCHI and stakeholders including, the private sector, parents and the Ghana Education Service (GES); the way educational policies influence the management of SMSSCHI; and the boundary issues in the day-to-day management of SSMCHI in Ghana. The research began with an analysis of the relevant literature. The empirical research was in two phases: Phase 1 involved visits to seven out of the 12 SMSSCHI in Ghana to understand day-to-day management practices. Phase 2 explored the relationships between schools and stakeholders in the day-to-day management of SMSSCHI in three schools. The data were analysed using the planning, organising, staffing, coordinating, reporting, budgeting (POSDCoRB) framework. The key findings were that day-to-day management practices were homogenous across study schools. This homogeneity stemmed from the use of centralized planning emanating from the GES to ensure conformity to set policies. This practice led to a limited adoption of strategic plans to address local needs. Organisational boundary issues emerged as significant in relation to the involvement of stakeholders in school management portrayed by the profound influence of the GES and very minimal involvement of other stakeholders as enshrined in the decentralisation policy of the GES. Societal conceptions of disability and the location of special schools influenced stakeholders' involvement in school management. The implications of the findings for policy and practice are discussed.