Introduction: The major cause of childhood diseases in Kenya is related to issues of poor sanitation. More than 19,500 people die every year from diarrhoea of which 17,100 are children. Diarrhoea accounts for 16% of deaths among children aged below 5 years hindering the achievement of Sustainable Development Goal 6. Pit latrine coverage in Meru County was 60%, thus encouraging open defecation (OD) (Njuguna, 2019). Aim: To analyse the effect of knowledge and culture on the utilization of pit latrines in Tigania East Sub-County. Methods: A descriptive cross-sectional survey involving 369 respondents selected by systematic random sampling from different households across the sub-county was utilized. Descriptive analysis, multiple regression, and odds ratios were pulled from SPSS 23 with the utilization of pit latrine being the dependent variable. Results: The study revealed a positive association between knowledge of pit latrines and utilization (R=.409, P=0.00) (x 2 =13.49, P=0.00). Knowledgeable respondents were 1.83 times more likely to utilize pit latrines that those who were not exposed. The study revealed that a positive relationship exists between the socio-cultural factors and taboos on the decisions to buy the upgrades on the utilization (R=.576, P=0.00), (F=55.823, P=0.00) and (X 2 =36.671, P=0.00). The study found a strong negative association between taboos with utilization (R=.398, P=0.00), (F=21.112, P=0.00). Conclusion: Partnerships with donors striving to increase social marketing curbing taboos against utilization are very essential in Tigania East. Campaigns to improve sanitation knowledge targeting both Men and Women are recommended.