Malaria remains a leading cause of morbidity and mortality among children under five in Nigeria. This study assessed malaria prevention, ownership and utilization of control tools, and environmental practices among caregivers of under-five children in Ahoada East Local Government Area (LGA), Rivers State, to identify gaps between access and effective use of preventive measures. A community-based cross-sectional survey was conducted across three randomly selected communities in Ahoada East LGA. A total of 381 caregivers were recruited using systematic sampling. Data were collected using a structured, interviewer-administered questionnaire and analyzed using descriptive. Descriptive statistics was used to summarize socio-demographic characteristics and malaria control practice. Most respondents were female (54.8%) with a mean age of 37.8 (±10.0) years. While 64.2% of households owned at least one mosquito net and 59.0% reported possessing insecticide-treated nets (ITNs), only 30.9% of under-five children had slept under a net in the prior three months. Frequency of regular ITN use was low (16.4% always), and common barriers to ITN use included breathing difficulties (14.5%), perceived discomfort/laziness (10.1%), child disinterest (8.8%) and cost (7.3%). Environmental practices were inconsistent: 43.6% always burned refuse, 23.6% always cleaned gutters, and 46.2% lived near stagnant water bodies. High ownership of nets in Ahoada East LGA has not translated into consistent protection of under-five children. Closing this gap requires targeted behavior-change communication, context-appropriate ITN designs for hot climates, integrated community environmental management, and empowerment of local health workers and caregivers to sustain proper use of preventive measures.