He was a parish priest until his appointment to be archdeacon of Sunyani in 1986, and became a canon of Kumasi cathedral in 1994.

He was a forces chaplain in the Ghanaian Army, holding the rank of major when he was elected the third bishop of the Diocese of Kumasi on 20 November 1998.

Sarfo was elected the first Metropolitan archbishop of the Internal Province of Ghana on its creation on 29 September 2012.

Unlike his two predecessors, he is seen as a supporter of reconciliation between the liberal and conservative wings of the Anglican Communion.

[2] He still attended the 3rd Provincial Assembly of the Anglican Church in North America, in Wheaton, Illinois, in June 2017.