In the last decade the role of knowledge management practices in business organizations has been emphasized by practioners, academics and entrepreneurs. Ironically, most of these studies have focused on large organizations, yet others have predominantly focused on secondary literature of past studies for their findings. In addition, some studies have focused on particular aspects like tacit or explicit knowledge without giving a clue on the relationship to performance using both. This study sought to find out the effect of knowledge management practices on organizational performance with particular reference to MSMEs, thereby filling the gap on smaller organizations. The study was also empirical and addressed both tacit and explicit forms of knowledge. The study was guided by knowledge based view theory of the firm. The objective of the study was to find out the effect of organizational learning, knowledge sharing, and knowledge acquisition on Micro, Small and Medium Enterprise performance in Migori County, Kenya. The study was conducted by cross- sectional survey, data being collected in the month of March and April 2014 using questionnaire and structured interview responses from a sample of 46 owner and 110 employed managers of MSMEs randomly selected from the accessible population using stratified random sampling technique. Cronbach alpha was used to test reliability. The data was analyzed using both descriptive as well as inferential statistics. The study found that knowledge sharing had a significantly positive effect on MSMEs performance, whereas organizational learning and knowledge acquisition had positive but insignificant effects on MSMEs performance in Migori County, Kenya. The study recommends that MSMEs be encouraged to facilitate implementation of knowledge sharing so as to realize significant improvements in their performance. The study concludes that MSMEs must embrace knowledge management practices, in particular knowledge sharing for their enhanced performance.