[9][10] Between 1992 and 1995 Appiah served as the assistant coach for his former club Asante Kotoko including deputizing under Malik Jabir.

[14] James Kwesi Appiah was Ghana's assistant coach between 2007 and 2012 serving under Claude Le Roy and Milovan Rajevac.

[16] He was appointed as the Head coach of the Ghana national team in April 2012,[17][18] describing himself as "the underdog" in the process.

[27] In April 2017 he was re-appointed as the coach of the Ghana national team, replacing former Chelsea manager Avram Grant.

[33] In September 2023, Appiah became the head coach of the Sudan national football team, whilst still working as Technical Director of Asante Kotoko in a joint role.