The study assessed antimicrobial drug use, pattern, and the occurrence of residues in farmed fish, as well as the level of awareness of drug residues amongst fish farmers in Kaduna State. A total of 300 fish samples from 30 farms in the three senatorial districts of Kaduna State were screened for the presence of antimicrobial drug residues. One hundred questionnaires were administered to fish farmers. Out of the 300 fish samples screened, antimicrobial drug residues were detected in 73.70%. An overall prevalence of 73.70% was obtained, while the prevalence of 63, 74, and 84% was obtained from Kaduna North, Central, and South senatorial districts respectively. From the questionnaire responses, the use of antimicrobial drugs in fish ponds was common (91.86%); with tetracycline (63.41%) being the most frequently used. Self-prescription and administration of drugs by farmers (67.86%) were more in number than those who consult veterinarians for prescription and drug administration. The level of awareness on antimicrobial drug residues in fish and dangers associated with the use and consumption of these residues were very low. Furthermore, the majority of the farmers did not observe antibiotic withdrawal periods before sales of fish to consumers. This study has established a high prevalence of antimicrobial drug residues in farmed fish in the study area. In addition, awareness of the dangers and public health implications of antimicrobial drug residues in fish amongst farmers in Kaduna is low. Therefore, the use of the antimicrobial drug in aquaculture should be regulated and farmers should be encouraged to use immunostimulators or probiotics for disease control and prevention, to safeguard the general populace from the hazards associated with drug residues in fish.