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ABSTRACT ObjectiveExtreme climatic events, like droughts, are increasing in frequency and severity. Droughts disrupt community livelihoods and resources with serious implications for human biology. This study investigated how chronic stress, measured by fingernail cortisol concentration (FCC), and water insecurity status were predictive of C‐reactive protein (CRP), a biomarker of inflammation, during a historic drought among Daasanach seminomadic pastoralists. MethodsData were collected at the height of the 2022 drought from 128 Daasanach household heads aged 16–80 years in northern Kenya using household surveys, anthropometric measurements, and dried blood spots to assess CRP levels and fingernails to assess FCC. We employed mixed‐effects linear and logistic regression models to examine the relationships between log‐transformed FCC, high water insecurity status measured via the Household Water Insecurity Experiences (HWISE ≥ 24) scale, and serum‐equivalent CRP (log‐transformed and dichotomized at mild, low‐grade inflammation ≥ 1 mg/L) adjusted for covariates. ResultsThe mean serum‐equivalent CRP was 4.1 mg/L and 56.3% of Daasanach adults had at least mild, low‐grade inflammation. Linear models indicated that ln(FCC) was positively associated with ln(CRP) (β = 0.56, SE = 0.12;p < 0.001). Further, logistic models demonstrated that ln(FCC) (OR = 2.69, 95% CI: 1.84–3.95;p < 0.001) and high water insecurity (OR = 2.23, 95% CI: 1.34–3.72;p = 0.002) were both associated with greater odds of low‐grade inflammation. ConclusionThis study provides evidence for how chronic stress and severe water insecurity may impact inflammation levels among pastoralists during drought. Since inflammation is central to cardiometabolic disease etiology, this is an additional reason to mitigate the negative health impacts of droughts and water insecurity exacerbated by climate change.