The purpose of this study was to qualitatively assess the state of information technology (IT) business alignment among Ghanaian universities and to identify factors that influence the achievement of four key dimensions of the concept. Studies show that factors influencing the achievement of the concept remain underexplored and research coverage for both developing economies and the higher education sector trails behind other sectors and developed economies. A two-round online Delphi technique was employed to elicit responses from personnel in IT leadership positions using Schlosser et al. (2012) alignment dimensions model as a lens. Findings suggest that IT investment is often aligned with institutional goals and that IT-business artifact mapping, IT-business partnerships, closing the IT-business communication gap, and technical skills and knowledge of IT staff are among key factors that influence the achievement of the intellectual, social, human, and environmental dimensions of IT-business alignment, respectively. Implications are also discussed.