Fish smoking using biomass fuel is an important livelihood for women living in the coastal regions of Ghana and may contribute to anaemia risk. We assessed whether women who smoke fish as their primary livelihood are at increased risk of anaemia compared to women in other livelihoods in the Central Region of Ghana. We conducted a comparative cross-sectional study of 330 randomly selected adult women (18–49 years) whose primary livelihood was either fish smoking (FSL) involving the burning of biomass fuel (n = 175) or other livelihoods (OL) not involving burning of firewood (n = 155). Data on participants’ recent diet were collected from a single, quantitative 24-h dietary recall and qualitative 7-day food frequency questionnaire of animal-source food (ASF) consumption. We further assessed participants’ haemoglobin concentration using the Urit 12 Hemocue system. We compared total iron intakes, the proportion of dietary iron from animal and