Worldwide HIV prevalence among Men who have Sex with Men (MSM) is 2 -20 times higher than that of general population. We conduct cross-sectional stud in four randomly selected districts.(Tanga, Pangani, Muheza, Korogwe of Tanga region Tanzania) to determine prevalence of HIV and sexual risk behaviors .A total of 266 MSM who aged above 18 and recruited at project of Most at risk population project conducted with Tanga Aids Working Group Organization were involved in study. HIV prevalence was found to be 33.8%. Bisexuality 44 (54.1%), multiple partnership (86.8 %), inconsistence use of condoms 170 (63.9) and participation in group sex 171 (64.3%) risk behaviors were reported. HIV was associated with number of sexual partners AOR 3.12(95% CI: 1.07 -5.78) and history of group sex AOR 1.535(95% CI: 0.79-4.027). We learned that the prevalence of HIV to MSM is high thus there is need to design and scale up the specific intervention to reduce the burden. Key words: HIV, Predictors, Men who have Sex with Men, Tanga region, Tanzania