Mastitis, an inflammation of the mammary glands, is one of the most common and costly diseases affecting dairy cattle worldwide, particularly in smallholder dairy farming systems in Kenya. This study aimed to evaluate treatment strategies and antibiotic usage practices in managing mastitis on Kenyan smallholder dairy farms. A cross-sectional survey was conducted involving 150 smallholder dairy farmers in central and Rift Valley regions of Kenya. Data was collected through structured interviews and on-farm observations. The study found that most farmers relied on antibiotics for mastitis treatment, with common drugs including penicillin, oxytetracycline, and ampicillin. However, there was limited knowledge regarding appropriate dosing, withdrawal periods, and the risks of antibiotic resistance. Additionally, most farmers lacked access to veterinary advice, and treatment decisions were often based on past experiences rather than scientific guidelines. This study highlights the need for improved education on mastitis management and antibiotic stewardship to enhance both animal welfare and public health.