Rift Valley fever (RVF) is a viral, vector borne zoonosis that has significant threat to livestock health and production and public health in Africa. Recent outbreaks have led to high livestock mortalities and human morbidity and socio economic impacts in Garissa. To assess the level of knowledge of pastoralists to causation and transmission risk factors and describe their attitude and practices in response to RVF outbreaks and management in the context of climate change shocks. To estimate the livelihood losses and burden impacts in Garissa. A population based cross sectional household survey was conducted in March 2012 and March 2013 in four hotspots. A multistage purposive sampling was used to identify 250 participants who included pastoralists, veterinary and medical personnel and livestock traders. KAP evaluation was by questionnaires in depth key informant interviews and focus group discussions. Participatory rural appraisal tools were used to assess the economic significance of the RVF outbreaks, risk factors and management costs. 185 respondents (74%) had good knowledge of RVF (symptoms scored >50%) and risk factor analysis indicated > 150 (60%) understood the consumption of meat of dead or infected animal, milk, touching aborted foetuses caused disease. Estimated lost revenue due to closure of livestock markets and bans was over Ksh.3 billion. Intervention costs and burden of the outbreaks is discussed. There is good knowledge and attitude on RVF risk, transmission and control. It re-emergence is associated with negative impacts on livelihoods and economic endpoints in Garissa.