The aim of this study was to confirm the level of availability of essential medicines in public hospitals in Kenya and the factors leading to this. A cross-section approach was adopted for the research which was conducted across several public hospitals in Nakuru County. Data was collected using questionnaires as the main tool. The findings revealed that majority of the essential medicines that include common antibiotics, common analgesics, antihypertensives, emergency drugs and pediatric formulations were found to be stocked out. Stock outs were caused by poor distribution (91.2%), issues of funding (58%), inappropriate selection (58%), and irrational use (56%) of essential medicines.