Aquaculture is among the fastest growing industry contributing 16% of the animal source of protein consumed by humans globally. In Uganda major farmed species are Nile tilapia and African catfish. Efforts by the government to improve the industry have largely been geared towards financial investments, quality feed and seed neglecting fish health as one of the constraints to production. This study aimed at finding out the factors limiting farmers from adopting the various fish health management practices recommended. A total of twenty four fish farms in Wakiso District were assessed using a cross sectional study design. A highly significant number (87.5%) (Chi-square value (χ2) =21, n=24, p=0.001) of farmers had a fish health management plan in place, all of them fed their fish, only 37.5% had a biosecurity protocol in place while 62.5% didn’t have. Treatments, carcass disposal, cleaning of equipment and isolation were done to some extent by those who had experienced a fish health challenge on their farms. None of the farms assessed utilised vaccinations and plant extract use for management of fish diseases. This was largely due lack of knowledge about these strategies. Other farmers thought some of the fish health management practices were not relevant/necessary as they had never experienced any fish health challenge on their farms. It was observed that disease occurrence, knowledge and relevance were some of the influencing factors for farmers to adopt and implement fish health management practices. It is therefore important to disseminate important knowledge from research to the beneficiaries so as to build a sustainable industry.