Persistent yield declines driven by ecological pressures threaten livelihoods and food security, particularly among smallholder cocoa farmers. Sustainable intensification (SI) is widely promoted to address productivity and environmental challenges in smallholder agriculture, yet its welfare effects in cocoa systems remain poorly understood. We address this gap by evaluating the effects of integrated adoption of sustainable cocoa intensification practices (SCIPs) on yield, farm income, and household food security. The analysis draws data from 739 cocoa-farming households in Ghana. Four plot typologies, representing alternative SI pathways, is constructed using a multidimensional farm-level indicator framework. A Multinomial Endogenous Switching Regression model is used to examine the effect of alternative SI pathways on each outcome variable. The results indicate that adoption of SCIPs significantly increases cocoa yield by 34.0% (223.86 kg/ha) and farm income by 34.12% (GHS 1,325.49/ha). It also substantially improves household food security, reducing the Household Food Insecurity Access Scale and reduced Coping Strategies Index by 63.46% and 62.87%, respectively, while increasing the Household Food Consumption Score by 50.35%. However, households experience short-term food security declines during the transition to SI. Supporting farmers through these transition periods will be essential to ensuring widespread adoption. Policy and development interventions must move beyond fragmented approaches and prioritize bundled, system-wide strategies. Efforts must focus on ensuring efficient input markets and expanding effective extension services. In addition, targeted incentive mechanisms are essential to cushion cocoa farmers during transition periods to sustain adoption.