Global surface temperature has risen by ~0.2°C per decade over the past 30 years. In Kenya, mean annual temperature has increased by ~1.0°C since the 1960s (~0.21°Cper decade). Nakuru County has experienced shifts in both temperature and rainfall, with average daily highs rising by 1.5–2.0°C (23.3°C to 27.8°C) and lows by 1–2°C (11.1°Cto 12.8°C). Annual rainfall has declined by ~5–10% compared to early 2010s levels, with increasing variability in the onset and cessation of rains. These changes contribute to greater reliance on agrochemicals, driven by pest resistance and climate variability. Although Africa accounts for only 2–4% of global pesticide use, the continent faces disproportionately high exposure risks. Overuse and misuse of agrochemicals undermine environmental integrity, human health, and agricultural sustainability. This study investigated the effects of climate change on agrochemical use and the health of fresh produce farmers in Nakuru County. Specifically, it examined farmers’ socio-economic status, agrochemical use practices, occupational safety measures, the association between climate change and agrochemical use, and proposed health and safety interventions. A community-based cross-sectional design targeted rural fresh produce farmers routinely exposed to agrochemicals. A two-stage sampling technique was applied: random selection of sub-counties using probability proportional to size, followed by random household selection within clusters. The study accessed a sample size of 388. Quantitative data were collected using structured questionnaires, while key informant interviews (KII), focus group discussions (FGD), and observations provided qualitative data. Data were collected using Kobo Toolbox, exported to Excel, coded, and analyzed in SPSS version 28. Chi-square tested associations between categorical variables, while binomial regression measured statistical significance. Findings showed that agrochemical exposure undermines the health of farmers. Risk factors included financial constraints, years of farming experience, household income, farmer group membership, and type of farming. Farmers with more than 15 years of agrochemical use were 1.3 times more likely to develop adverse health effects compared to those with fewer years (p=0.006). Financially constrained farmers were five times more likely to develop health problems than those without constraints (p<0.01). Regression analysis established a statistically significant association between changes in weather patterns and agrochemical use decisions (p=0.005). Farmers noticing extreme weather were 1.2 times more likely to rely on expert advice or previous experience when making agrochemical use decisions. Overall, farmers with long term agrochemical use and financial challenges faced heightened health risks. 64.2%offarmers expressed willingness to adopt new technologies, shift towards organic farming, andreduce reliance on traditional agrochemicals. The study recommends targeted interventions by Nakuru County’s agriculture department to address financial barriers, such as promoting cooperative membership through agricultural extension services. A multisectoral approach, including the health department, should target experienced farmers for regular health screenings, refresher training, capacity building, and sensitization to enhances afeagrochemical use and strengthen occupational health and safety practices.