Delay in care seeking at health facilities for malaria related fever results into mortality of several children under five years. Both hospital and home-based care practices have contributed to delay in seeking care at the health facilities. However, few studies have investigated how home-based practices contribute to the delay. This study therefore employed a descriptive cross-sectional study to identify home-based practices that lead to delay in seeking care at health facilities among 199 caregivers with children under five years with malaria related fever at Mumias health centre, western Kenya. Semi-structured questionnaire and key informant interview guide were used to collect data from caregivers and health care providers respectively. Purposive sampling was used to select the study participants. The findings show that 60% (n=119) of caregivers present their children to health facility after 24 hours. However, 80% (n=159) and 82% (n=163) of them know the symptoms and causes of malaria respectively. The drugs administered by caregivers to children with fever were antimalarials, 24.1% (n=48), antipyretics, 25.6% (n=51), antibiotics, 6.5% (n=13), and combination of anti-malarial, antipyretic and anti-biotic, 5.5% (n=11). The sources of drugs were: retail shop, 10.1% (n=20), neighbours, 8.0% (n=16), chemist, 42.8% (n=84), and remnants from previous treatment, 2.0% (n=4). Interestingly, 32.0% (n=64) of decisions to seek care are made by the families and about 37.1% (n=74) do not seek care at the health facility. The study shows a delay in seeking care for malaria related fever at the health facility despite the caregivers aware of the symptoms and causes of malaria. Consequently, there is a need for health education to caregivers on health seeking care and importance of early treatment within 24 hours of developing malaria related fever. Also, shopkeepers, community health volunteers and private pharmacy proprietors should be sensitized and engaged on the seeking care for malaria related fever.