Tropical Africa experienced large changes in hydroclimatic conditions since the Last Glacial Maximum (LGM), ∼26.5 to 19 thousand years (ka or kyr) ago. The hydrogen isotopic composition of fossil leaf waxes (δDwax), assumed to record past variations in the hydrogen isotopic composition of precipitation (δDprecip), is increasingly being used to study past hydroclimatic change in Africa, and are commonly interpreted to reflect variation in the amount of precipitation through time (i.e., the amount effect). Although there are now many such δDprecip records from tropical Africa, there are few robust δDprecip records from easternmost equatorial Africa of sufficient length and resolution to evaluate the mechanisms governing hydroclimate variation during and since the LGM. We produced a new δDprecip record based on analyses of δDwax in sediment cores collected from Lake Rutundu, situated at an elevation of 3,078 meters above sea level (m asl) on Mt. Kenya. This record displays large variations in δDprecip corresponding with known climate events over the past 25 kyr, including D-enrichment during the Heinrich 1 stadial (H1) and the Younger Dryas (YD), and D-depletion during the Holocene portion of the African Humid Period (AHP). We also observe D-depletion during the LGM relative to the late Holocene, which, considering the amount effect, could be interpreted to imply that LGM climate conditions were wetter than today. However, because other hydroclimate proxies at this site indicate a drier LGM climate at Lake Rutundu, and since precipitation isotopes at this high-elevation site are likely influenced by different processes than at low elevations, we used a single-column Rayleigh distillation model to evaluate temperature and altitude-related effects on high-elevation δDprecip. This revealed that a change in the temperature lapse rate exerts strong control on δDprecip in this high-elevation setting, and that a steeper lapse rate could explain the observed D-depletion during the LGM at our site. Comparison of the Lake Rutundu δDprecip record with other leaf-wax based δDprecip records from East Africa indicates that changes in the meridional precipitation gradient associated with the mean annual position and intensity of the tropical rain belt, in turn driven by precessional insolation forcing, were likely a primary control on East African hydroclimate over the past 25 kyr, thereby contributing to overall regional drying during the LGM.