Background: Globally, about 25% of births occur with shorter intervals annually with over 12 million underage pregnancies mostly from Sub-Saharan Africa. Kenya records about 20% teenage pregnancies while Kilifi County reported 28.9%. In Kilifi County, 19.6% of births do not adhere to the 24-month birth-interval. The study focused on establishing accessibility factors associated with adherence to healthy timing and spacing of pregnancy (HTSP) among reproductive age women in Kilifi County, Kenya. Methods: A descriptive cross-sectional design was adopted with a sample of 293 respondents. All required approvals and consent were obtained. Quantitative data was collected using questionnaires. Descriptive data was analyzed using SPSS version 22.0 and inferential statistics computed through Chi-square tests. Results: About 60.1% respondents adhered to heathy timing and spacing of pregnancy, 69.4% teenage pregnancies occurred and 67.1% of women adhered to the 24-month inter-birth interval. Availability of family planning (FP) services (p=0.008), experience with providers (p=0.005), cost of accessing FP (p=0.001) and source of information (p=0.002) were associated with HTSP. Conclusions: About 4 out of 10 women of reproductive age in Kilifi County do not adhere to the recommended HTSP. Accessibility factors such as cost and availability of family planning services, source of information and experience with healthcare providers significantly influenced adherence to HTSP. The Ministry of Health and relevant stakeholders should scale up awareness activities, provide mobile clinics and concentrate on regular continuous medical education among healthcare providers to enhance their role in provision of reproductive health services.