This article describes the interactional patterns and linguistic structures associated with other-initiated repair in Siwu, a Kwa language spoken in eastern Ghana. Other-initiated repair is the set of techniques used by people to deal with problems in speaking, hearing and understanding. Formats for repair initiation in Siwu exploit language-specific resources like question words and noun class morphology. At the same time, the basic structure of the system bears a strong similarity to other-initiated repair in other languages. Practices described for Siwu thus are potentially of broader relevance to the study of other-initiated repair. This article documents how different prosodic realisations of repair initiators may index social actions and features of the speech event; how two distinct roles of repetition in repair initiators are kept apart by features of turn design; and what kinds of items can be treated as ‘dispensable’ in resayings. By charting how other-initiated repair uses local linguistic resources and yet is shaped by interactional needs that transcend particular languages, this study contributes to the growing field of pragmatic typology: the study of systems of language use and the principles that shape them.