Some babies and toddlers in parts of West Africa are considered spirit children—nonhumans sent from the forest to cause misfortune and destroy the family. These are usually deformed or ailing infants, or children whose births coincide with tragic events or who display unusual abilities. Aaron R. Denham offers a nuanced ethnographic study of this phenomenon in Northern Ghana that examines both the motivations of the families and the structural factors that lead to infanticide. He also turns the lens on the prevailing misunderstandings about this controversial practice. Denham offers vivid accounts of families’ life-and-death decisions that engage the complexity of the context, local meanings, and moral worlds of those confronting a spirit child.