Climate change, population growth, and uncontrolled urbanization threaten safe drinking water in Kenyan cities, causing shortages in quantity and quality. This study, conducted from October 2023 to July 2024, analyzed water samples from Nyakomisaro-Riana and Nyanchwa-Riana for fecal coliforms using APHA protocols. Data on waterborne diseases were obtained from Kisii Teaching and Referral Hospital, and household water sources were surveyed. Findings showed climate change reduced water availability and quality, with fecal coliforms increasing during rainy seasons. Over 70% of residents relied on alternative water sources. To address this, planned settlements with piped water, protected springs, regulated water testing, and public awareness campaigns are crucial. Water harvesting and community participation are essential for sustainable water management