Background: Cervical cancer is a leading cause of cancer-related deaths among women worldwide, especially in low- and middle-income countries. In Kenya, although the incidence is high, screening uptake remains low. Aim: This study examined how perceived risk, socio-cultural, and health system factors influence cervical cancer screening uptake among women aged 25–49 in Thika Sub-County, Kenya. Methods: A cross-sectional survey of 285 women was conducted using structured interviews. Data were analyzed using correlation and chi-square tests. Results: Perceived risks such as multiple sexual partners (χ² = 35.117, p < 0.01) and belief in the fatality of cervical cancer (χ² = 19.601, p < 0.01) were significantly associated with screening uptake. Socio-cultural influences—religious beliefs (r = 0.248), cultural perceptions (r = 0.249), and family influence (r = 0.313)—also impacted uptake. Health system factors, including program availability (χ² = 49.172, p < 0.01), sensitization by providers (χ² = 52.143, p < 0.01), and access (χ² = 9.896, p = 0.019), showed strong associations with screening behavior. Conclusion: A multifaceted approach involving community education, health system strengthening, and culturally sensitive outreach is essential to enhance cervical cancer screening rates in Kenya.