Aflatoxin contamination remains a major global food safety challenge, with serious implications on agriculture and public health. Kenya has frequently experienced outbreaks of acute and chronic aflatoxin poisoning over the years with adverse human health effects. Farmers respond to incidences of aflatoxin contamination using a myriad of control practices. This study evaluates the choice of aflatoxin contamination control practices among smallholder maize farmers in Kilifi County, an aflatoxin hotspot in the Coast region of Kenya. A Poisson regression model was employed on a sample of 270 farmers selected using a multistage sampling technique. The aflatoxin contamination control practices used by maize farmers in Kilifi County can broadly be categorized into pre-harvest practices (timely planting, pest control, use of improved seed varieties, and early harvesting) and postharvest practices (sorting, proper drying, and use of storage pesticides). The Poisson regression estimates reveal that aflatoxin awareness, access to extension services, wealth status, and gender were the most important drivers of farmers choice of aflatoxin contamination control practices in Kilifi County. Thus, policy initiatives that improve farmers awareness and access to information are recommended in improving maize farmers aflatoxin contamination knowledge and uptake of management practices. To be effective, such interventions must address gender and wealth differences.