Currently, there is a growing trend towards gathering children at orphanage centres (OCs) due to societal changes. This leaves many unanswered questions related to the quality of care offered to children living in OCs. This study aimed to examine care practices and support provided to children living in orphanage centers in Morogoro and Dar es Salaam regions. A cross sectional study design using a questionnaire, observations, anthropometric and biochemical measurements was used to collect the needed information. A total of 13 orphanage centers with 386 children were involved in the study. Both the supervisors of the OCs and children aged 5-18 years old were interviewed. Ninety five percent of children felt safe living in the OCs. However, 48.7% of the children were anaemic and 87.3% had excess iodine in the urine. Significant differences (P=0.003) were observed in the mean haemoglobin between males (12.0 mg/dl) and females (11.6 mg/dl). Furthermore, the prevalence of stunting was high (23.8%) with more male children (30%) being stunted than female children (18%). Morbidity level was high whereby 50.3% of the children reported to have been sick one month prior to this study. Foods most consumed were cereals (rice and stiff porridge) and pulses (beans). Also, the general consumption of vegetables and fruits was rare. Overall, living conditions in most of surveyed orphanages were poor and health-care inadequate in some orphanages, there were indications that access to foods was limited and quality of care was of substandard due to limited financial resources, lack of supervision, and minimal awareness of child development issues. Government and Non Governmental Organizations owned orphanage centres performed poor in care practices compared to Faith Based Organizations. Furthermore, regions wise orphanage centres located in Dar es Salaam performed poor in care practices compared to orphanage centres located in Morogoro region.The Ministry of Health and Social Welfare through the Tanzania Food and Nutrition Centre