This cross-sectional survey was to determine dietary diversity, nutrient intake, nutrition status and prevalence of childhood illnesses among pre-school children in Matungu division, Western Kenya. A total of 144 households were arrived at using multistage sampling, structured questionnaires with food frequency tables and 24-hour recalls were administered and anthropometric measurements taken. Linear regression tested statistical associations between variables. Epi Info was used to compute nutrition indices later assessed relative to National Centre for Health Statistics and World Health Organization. Only 3% of pre-school children had consumed highly diversified diets and consumption. Stunting was the most prevalent form of malnutrition and malaria was the most prevalent childhood infection. About 7%, 3.6% and 8.1% of changes in underweight, stunting and wasting, respectively, could be attributed to changes in dietary diversity. An r² of 0.284 was obtained between nutrition status and morbidity. To enhance children's nutrition and health status, efforts should be on strategies that increase dietary diversity.