It is noted globally that over 95 countries and territories have on going malaria transmission with an estimated 3.2 billion people who are at risk of getting infected. The World Health Organization (WHO) indicates that 214 million eople are infected with malaria worldwide and of these 438,000 cases result in deaths. Children below five years are the most susceptible to malaria illness which accounts for estimated deaths of 303,000 before reaching age five globally and 292,000 occur in the African region. In the current study, we determined the prevalence of malaria and the associated risk factors among children below 5 years attending Msambweni County Referral Hospital (MCRH). PREVALENCE OF MALARIA IN CHILDREN UNDER FIVE YEARS OF AGE IN MSAMBWENI KWALE COUNTY GRACE KITOTI PAUL KOSIYO RESULTS Among 1260 children, 11.5% (145) were positive for malaria; 89.7%, 6.9%, 2.1% and 1.2% of them were positive for P.f , P.m, p.o and mixed infections, respectively. Malaria infection was associated with favorable KWALE COUNTY, KENYA climatic factors of the area for the vector and socioeconomic characteristics of the residents. . Conclusion Prevalence of malaria is influenced by climatic factors such as: temperature, humidity, and rainfall patterns . Msambweni is geographically located on the low land with altitudes up to 825metres above sea level. Improved access to all malaria interventions and more research is needed in msambweni.