Food access insecurity is a worrying challenge worldwide with sub-Saharan Africa including Tanzania being the most affected. Although factors that influence household food access security and ways of coping with such factors have been examined, little has been reported on how these coping strategies vary along the urban-rural continuum especially in medium-sized towns. The study on which this manuscript is based assessed whether food access insecurity strategies employed by households are similar along the urban-rural continuum. In addition, the study assessed whether the above-mentioned strategies contribute to building and improving households’ resilience to food access insecurity. The study employed a cross-sectional research design whereby a sample of 279 households was drawn using a multi-stage sampling procedure. Primary data was the key source of information for the study and was collected using a structured 70 questionnaire. Data were analysed mainly descriptively. Chi-square test (X 2 ) was performed to assess the relationship between each employed coping strategy and the spatial location of the household. Additionally, the Multi-layered social resilience framework was employed to determine whether these strategies contribute to improving household’s resilience to food access insecurity. Results show that the surveyed households use a number of coping strategies, most of which vary significantly from one spatial entity to another. Results also show that these strategies do not improve households’ resilience to food access insecurity as they erode household’s own resilience. Thus, it is concluded that food access insecurity coping strategies vary greatly among households along the urban-rural continuum. In addition, the surveyed households employ mainly reactive strategies, which may not be considered as proper in the realm of resilience building. It is hereby recommended that poor households, particularly in those rural areas be supported to diversify their incomes so as to be able to employ resilient building strategies when they experience food shortages.