Traditional music in many communities faces increasing erosion as modernisation disrupts intergenerational transmission. In Ghana, this trend has been documented among smaller ethnic groups in the Akwapem region. The Larteh people — an Akwapem community in Ghana's Eastern Region — possess a folk music tradition that remains entirely absent from peer-reviewed scholarship and African piano repertoire, a gap confirmed through searches of Scopus, RILM Abstracts, and AJOL. This study addressed that gap by adapting ten Larteh folktunes from the Ahenease and Kubease communities for solo piano. The ten tunes were selected from twenty collected over six months of fieldwork, based on melodic distinctiveness, rhythmic complexity, and representativeness across six documented social functions. Using creative ethnomusicology as its research design, the study gathered folktunes through semi-structured interviews with thirteen participants — eight elder musicians, three community elders, and two music teachers — alongside recorded live performances and ear-based transcription. Ten original piano compositions were produced, blending Larteh musical idioms with Western compositional techniques grounded in syncretism and intercultural composition theories. Cultural fidelity was verified through two rounds of community review, comparative score analysis, and evaluation against original recordings. The findings confirm that Larteh compound rhythms, call-and-response patterns, and pentatonic melodic contours can be rendered recognisably within a piano medium when guided by rigorous fieldwork and harmonic restraint. The study contributes ten piano scores to Ghanaian art music, offers a replicable compositional methodology for adapting under-researched African folk traditions, and identifies cross-rhythmic structures as a key compositional resource. Ten original piano compositions were produced, blending Larteh musical idioms with Western compositional techniques grounded in syncretism and intercultural composition theories. Cultural fidelity was verified through two rounds of community review, comparative score analysis, and evaluation against original recordings. The findings confirm that Larteh compound rhythms, call-and-response patterns, and pentatonic melodic contours can be rendered recognisably within a piano medium when guided by rigorous fieldwork and harmonic restraint. The study contributes ten piano scores to Ghanaian art music, offers a replicable compositional methodology for adapting under-researched African folk traditions, and identifies cross-rhythmic structures as a key compositional resource.