From the very first whistle, both sides signalled their attacking intent and although South Africa had the better opportunities in the first half, Ghana also had their chances too. Ransford Osei and Adiyiah combined well on the edge of the box before the latter blazed over the bar, while Abeiku Quansah saw his well-struck free-kick well saved by Darren Keet.
However, South Africa raised their game midway through the half. Helped by the fact that Emmanuel Agyemang-Badu was sitting deep and the Ghanaians were missing the energy of the suspended Mohammed Rabiu, the Amajita's midfield trio of Dylon Claasen, Kamohelo Mokotjo and Thulani Serero began to see more of the ball and dominate proceedings.
Kermit Erasmus had their first real chance after twisting and turning his marker and firing a low shot straight at Daniel Agyei. Shortly afterwards, Sameehg Doutie's throw-in was too high for Erasmus, but went straight through to Sibusiso Khumalo, who struck a low drive which the keeper gathered at the second attempt.
Agyei then pulled off three fine saves to keep the scoreline level. First, he tipped Serero's curling free-kick over the bar and then denied Doutie's with another acrobatic stop when the South African's dipping shot from the right flank looked destined to creep into the top corner. Then, with the same player clean through on goal, the Liberty stopper rushed off his line to save bravely at the forward's feet.
There were further warning signs for Ghana when Thulani Hlatshwayo headed just wide from Serero's corner and at the other end Keet did well to block Adyiah's shot from close range. Sellas Tetteh would have been the happier of the two coaches to have heard the half-time whistle. However, it was South Africa who started the second half the brighter of the teams.
Substitute Mandla Masango fired narrowly over from the edge of the box and when Ghana failed to clear Claasen's corner in the 57th minute, Erasmus forced Agyei into a low save. A minute later, Erasmus made Ghana pay for another defensive lapse. Springing the Black Satellites' offside trap, Erasmus brilliantly controlled Khumalo's quick free-kick, rounded the keeper and slotted home.
With 32 minutes remaining, Ghana poured men forward in search of an equaliser, but found their route to goal increasingly congested. However, after winning a free-kick on the left hand side, David Addy whipped in the perfect ball, which Andre Ayew deflected past Keet and into the net. Following the goal, Ghana used the flanks to good effect, with Addy and Samuel Inkoom providing the ammunition, but Adiyiah and Osei failed to test the keeper.
Osei was replaced at the final whistle by Opoku Agyemang, but it was the Satellites other striker Adiyiah who was at the centre of things in the first period of extra time. First, Inkoom supplied him with a tremendous through ball, but he saw his low shot saved. However, in the 99th minute, after receiving the ball from Addy with his back to goal, he turned sharply and fired the ball high into the net from the 25 yards.
The striker went close on two further occasions in extra time, first when he was inches away from turning Addy's cross into the goal and then when he forced a brilliant save from Keet with a rising drive from the edge of the box. By this stage, the Amajita were visibly tiring and struggled to get out of their own half in the second period, but were given brief hope with the sending off of Agyemang for a second bookable offence.
However, Ghana held out to set up a clash with Korea Republic in Suez on Friday and watching coach Hong Myung-Bo will know that his side have a real battle on their hands against the African champions.