Hygiene is no new concept to humanity, more so where the hotel industry is involved. The world is becoming a busy globe and meals that were once shared at home are now being provided more and more in eating establishments. People in this case have to trust third parties to handle the preparation of their food and the question about how that food is handled is brought up. This is the same question posed as far as hotel establishments are concerned in Kenya. Can one really trust the people handling their food in hotel? What role does hygiene and sanitation, especially of the food play in convincing individuals to eat in a particular hotel establishment. To be able to answer this question, the study embarked on a study that sampled prominent ethical restaurant within Nairobi City County and interacted with 120 sampled respondents through stratification. The respondents participated in the study by answering a series of questions outlined in a structured questionnaire. The respondents were drawn from various ranks in the establishment ranging from the managers and owners of the restaurants. Data collected was analyzed by use of descriptive statistics with the aid of statistical packages for social sciences and presented in the form of tables, charts and graphs. The study findings showed that restaurants had clear policies for health and safety, though compliance was found to be a challenge leading to unhygienic handling of food and customer dissatisfaction. Structurally, health measures were ineffective in some restaurants, leading to customer discomfort and low frequency of visits. Customers expect a restaurant with good health on first instinct and determined preference. The study however established that the management responded to customer complaints and implemented hygiene changes. As such, it can be concluded that health measures, customer expectations and perceptions had an effect on customer satisfaction and the performance of the restaurants. The study recommends regular capacity building of staff on health and sanitation policies and standards. Also recommended were regular reviews of the restaurant buildings to ensure conducive environment for dining should be undertaken. Training of staff on food handling as well as effective supervision would enhance customer experience at the restaurants. The study recommends further studies in evaluate the effect of staff skills on customer satisfaction in restaurants and assessment of the effect of ethnic cuisines on the performance of restaurants.