This paper examined organic fertilizer adoption and its effects on two household food security indicators and gender-based farm labor use among smallholder farmers in Northern Ghana. An endogenous switching regression analysis shows that observed and unobserved farmer background factors determine farmers' decision to adopt organic fertilizer as well as the outcomes from adoption. On average, adoption is associated with an 11% increase in per capita food consumption and a 55% reduction in household food gap duration. Adoption is also related to an increased labor use by 5.9 (90%) of female worker days and 1.3 (9%) of male worker days per acre, placing nearly all (82%) of the increased labor burden on female farmhands. We recommend mitigation of factors that hinder farmers from adopting the input and provision of female-user-friendly labor-saving devices for organic fertilizer use tasks.