The study focused on Monitoring and Evaluation practices on the performance of Integrated Management of Acute Malnutrition (IMAM). The specific objectives were: to assess the effects of Surveillance monitoring on the performance of IMAM, to determine the impact of Implementation monitoring on the performance of IMAM, and to analyze the effects of evaluation relevance on the performance of IMAM. The study was conducted in the County of Kajiado in Kenya. The descriptive design was adopted and involved a mixed-method approach. A target population of 54 and a sample size of 48 were used to obtain data. Purposive sampling was used, whereas data were gathered using a close-ended questionnaire and structured interview. Data were analyzed using Mean and Standard Deviation, Pearson Correlation, and Multiple Regression. The study found that surveillance monitoring, implementation monitoring, and evaluation relevance affected the performance of IMAM. The correlation coefficient was 0.872, 0.889, and 0.864, respectively, Sig. 0.000, p <0.05, which meant the relationship between surveillance monitoring, implementation monitoring, evaluation relevance, and performance of IMAM project was strong. The regression analysis showed that surveillance monitoring positively and significantly affects the performance of IMAM by 37.3%, implementation monitoring impacts positively and significantly the performance of IMAM by 59.2%, and evaluation relevance positively and significantly affects the performance of IMAM by 25.7%. These quantitative results were supported by the qualitative results. The study concluded that surveillance monitoring, implementation monitoring, and evaluation relevance statements affect the performance of IMAM and recommended the government and project managers increase surveillance monitoring in projects, enhance implementation monitoring in projects and enhance evaluation relevance in projects by making sure that there are clear Indicators of evaluation and well-thought significance of evaluation.