International Journal of TROPICAL DISEASE & Health, 2017; 22(1): 1-15, 2017; Article no.IJTDH.3078Aims: To assess schistosomiasis occurence and identify risk factors influencing its transmission in different surface irrigation schemes in Morogoro and Kilimanjaro Regions of Tanzania. Study Design: Cross-sectional research design was used and Schistosomiasis recorded cases for ten years (January 2002 to December 2011) were collected from health facilities located nearby the irrigation schemes. Place and Duration of Study: Mkindo, Chabi and Mwega (Morogoro Region) and Kikafu Chini, Lower Moshi and Njoro (Kilimanjaro Region) between October and December, 2011. Methodology: Out of 378 respondents selected; 240 in the questionnaire survey, 96 in the Focus Group Discussions and 42 in the Key informant interviews. In each scheme 40 farmers practicing irrigation rice farming were interviewed. Binary logistic regression was used to test association between schistosomiasis infection and a number of predictors such as: age, sex, education, wearing gumboots during irrigation activities, washing clothes and household utensils and cleaning farming tools in canals. Data on activities involving water contacts, water management practices and people’s behaviour were collected through questionnaires and observations. Moreover, tables and figure were used to describe the data. Results: There was no significant statistical association between predictors and disease occurrence in both Regions (P>0.05). The findings further show that lack of toilets in the schemes and excessive vegetation growth in irrigation and drainage canals have lead to prominence of schistosomiasis infection. Education in both Morogoro and Kilimanjaro schemes highly contribute to occurrence of the disease (Walds 2.057 and 1.164 respectively). Conclusion: Although the level of schistosomiasis occurance is slightly reducing in the study areas the government of Tanzania through the Ministry of Health and Social Welfare should have a plan of schistosomiasis control to communities engaged in irrigation farming and those who live close to irrigation schemes. This should be done through providing praziquantel tablets to communities at least once in a year.