Fruit consumption in Eastern Africa remains critically below recommended dietary levels, contributing to persistent micronutrient deficiencies, yet little is known about the gender-specific dynamics influencing fruit production, consumption, and marketing. This study explores the patterns and determinants of fruit-related behaviors among rural households in Western Kenya, focusing on gender-disaggregated preferences, attitudes, and decision-making. A survey was conducted in July–August 2013 across five agro-ecological zones (AEZs), involving 370 randomly selected households from 15 villages. Individual interviews targeted women responsible for food and nutrition within the household. Findings reveal significant disparities in fruit consumption frequency between women, their husbands, and children (P<0.001), with women consuming fruits least often, despite 89% of women and 77% of children expressing a desire to increase intake. Fruit consumption frequency showed a slight positive correlation with household wealth (P=0.030) and a negative correlation with women's age (P<0.001). The average fruit intake for women was only 54g per day, again negatively associated with age (P=0.014). While 80% of households engaged in fruit cultivation, 55% consumed the produce exclusively, 5% sold it only, and 38% did both. Proceeds from fruit sales were predominantly used to purchase other foods (66%), mainly starchy staples (43%), and non-food items (22%). Despite favorable agro-ecological conditions for fruit production, consumption remains inadequate. The data suggest that wealth plays a minor role, whereas age is a more significant factor in consumption levels. As most participants wish to increase fruit intake, targeted efforts to boost production and ensure fruits are prioritized for household nutrition could help address hidden hunger in the region.