This study investigates how low-income rural populations face health risks due to a lack of clean energy access, leading to respiratory diseases and high healthcare costs. Strategies promoting clean energy adoption and affordable healthcare are crucial to addressing these issues. However, policies need evidence-based support. This research explores the interplay among income levels, household energy choices, and healthcare expenses. Conducted in Kisii County with 384 randomly sampled households using a cross-sectional design, the study quantitatively analyzed data. Results indicate a significant relationship between energy sources and healthcare costs, moderated by income. Over two-thirds of rural households rely on polluting fuels like kerosene and biomass, increasing infection risks and healthcare spending. These findings advocate for funding cleaner technologies to mitigate healthcare expenses among vulnerable rural communities.