Introduction: The incidence of allergy-related diseases (ARDs), such as allergic conjunctivitis (AC), eczema, and rhinitis (AR), has increased globally in recent decades. A single cause for this increase cannot be identified. The prevalence of these conditions is higher in Africa and other low- and middle-income countries (LMICs). Objective: This study aimed to assess the factors contributing to allergic conjunctivitis in children aged < five years at Murang’a County Referral Hospital, Kenya. Design: This was A Hospital-based cross-sectional study. Multi-staged sampling followed by systematic purpose sampling was used to reach caregiver-child pairs. Setting: Murang’a County Referral Hospital. Participants: A total of 104 children aged < 5 years were included in the study, consisting of 82 (78.8%) males and 22 (21.2%) females. Results: The results of this study revealed that the majority of the children with conjunctivitis resided in rural areas 52.9%). Family history of allergic conditions (p<0.0001), exposure to dust (p<0.0001), and children whose caregivers were farmers (p<0.001) were likely to have conjunctivitis at 60.6%, 71.2%, and 65.4%. The majority of the patients experienced itching in the eyes and red eyes 95.2% and 59.6%). AR was the most common morbidity 42.3% while atopic dermatitis and asthma accounted for 23.1% and 19.2% respectively. Other factors associated with AC included the use of firewood and charcoal. Conclusion: Allergic conditions remain a public health concern among children below five years of age. The most common precipitating factors are dust, hot humid weather, pesticide use, and smoke from use of either firewood or charcoal. Therefore, emphasis should be placed on addressing the prevention of disease, health education, and home management of acute symptoms. Key words: [ Allergic conjunctivitis, Under five, risk factors]