Background: Clinical efficacy of the use of antiretroviral drugs (ARVs) by HIV-negative individuals to prevent sexual transmission of HIV has been extensively reported. Global estimates indicate that adolescent girls and young women accounts for 68% of the new HIV acquisitions among young people. Oral Pre -exposure prophylaxis (PrEP) use in adolescent girls and young women remains suboptimal in Kenya despite Pre-Exposure Prophylaxis being scaled up nationally. Objective: To establish determinants for utilization of pre-exposure prophylaxis among adolescent girls and young women between 15 to 24 years of age in KisumuMunicipality, Kisumu County.  Design:A cross sectional study. Setting: Kajulu and Manyatta wards in Kisumu Municipality, Kisumu County, Kenya Subjects/Participants: Four Hundred and twenty two (422) participants drawn from a target population of 4000. The study used systematic sampling method. Semi-structured questionnaires were used to collect quantitative and qualitative data.  Results: There was statistically significant association between girls and young women aged 15-24 years preferring PrEP and utilization of pre-exposure prophylaxis at a 5% level of significance (p-value = 0.000<0.05, X2 =50.892a, df 4), an association between PrEP services being offered for free or at a cost and utilization of pre-exposure prophylaxis at a 5% level of significance (p-value = 0.000<0.05, 2 =89.799a, df 2) , an association  between nearest facility where girls and young women aged 15-24 years can access PrEP and utilization of PrEP  at 5% level of significance (p-value = 0.000<0.05, 2 =30.465 a, df 3),  association between quality of PrEP services in health facilities and utilization of PrEP was found to be statistically significant at a 5% level of significance (p value=0.011<0.05, 2 =,13.111adf 4), an association between recommendation/strategies given by respondents to improve uptake of PrEP and utilization of PrEP was statistically significant at 5% level of significance (p-value = 0.000<0.05, 2 =,70.476adf 4), an association between community talking about PrEP and utilization of PrEP was found to be statistically significant at a 5% level of significance (p-value = 0.004<0.05, 2 =8.515a, df 1), how the community portray the use of PrEP and utilization of PrEP was statistically significant at a 5% level of significance (p-value = 0.048<0.05, 2 =7.884aa, df 3) , association between social pressures within the community and utilization of PrEP was found to be statistically significant at a 5% level of significance (p value=0.001<0.05, 2 =,13.690adf 4) Conclusion: Socio-economic, Socio-Behavioural, Structural and Socio Culture played a greater role in determining utilization of pre-exposure prophylaxis among adolescent girls and young women between the ages of 15 to 24 years in Kisumu municipality, Kisumu County.