Urban areas face significant challenges in maintaining water quality amidst increasing urbanization and changing climatic patterns. This study investigates the complex interplay between meteorological variables and water quality parameters in Nairobi City, focusing on the impacts of rainfall and temperature on surface water quality. Data from multiple sources, including the Water Resources Authority, Nairobi Water and Sewerage Company, and the World Bank's Climate Change Knowledge Portal, were analyzed to assess the relationships between meteorological variables (rainfall and temperature) and water quality parameters (such as electroconductivity, biochemical oxygen demand, chloride, and pH). The analysis reveals varying impacts of rainfall and temperature on different water quality parameters. While parameters like iron and pH show strong relationships with both rainfall and temperature, others such as ammonia and nitrate exhibit moderate relationships. Additionally, the study highlights the influence of runoff, urbanization, and industrial activities on water quality, emphasizing the need for holistic management approaches. Recommendations encompass the establishment of annual publications on Nairobi River water quality, online accessibility of water quality data, development of hydrological models, spatial analysis, and fostering cross-disciplinary research collaborations. Implementing these recommendations can enhance water quality management practices, mitigate risks, and safeguard environmental integrity in Nairobi City.