International Journal of TROPICAL DISEASE & Health 2013, Vol. 3(1): PP13-24,Aim: To assess differences in schistosomiasis knowledge in farmers working in traditional, improved traditional and modern irrigation schemes in Tanzania. Study Design: A cross-sectional survey among farmers practicing irrigation rice farming, in 2 different regions and 6 different irrigation systems. Place and Duration of Study: The study was carried out between November and December 2011 in the Morogoro and Kilimanjaro Regions, Tanzania. Methodology: Equal number of irrigators in each scheme was employed. Irrigators were chosen randomly by the researcher from the list of all farmers actually engaged in rice irrigation farming provided by the village governments in the six schemes. Two hundred and fourty samples (240) were used, 120 from each region (40 farmers practicing irrigation rice farming in each scheme). Independent sample t-test was used for testing schistosomiasis knowledge differences among irrigators between schemes with the same design and construction of their infrastructures between the two regions. Results: More than 88% of irrigators surveyed in Kilimanjaro schemes had better knowledge regarding to all schistosmiasis items asked compared to those in Morogoro, particularly Chabi scheme-traditional. There were significant difference on irrigators knowledge on schistosomiasis symptoms (P<0.001), and predisposing factors (P<0.001) between Morogoro and Kilimanjaro Modern schemes. Knowledge on predisposing factors differed significantly (P<0.001) between irrigators in Morogoro and Kilimanjaro improved traditional schemes. Moreover significant difference were noted on irrigators knowledge on schistosomiasis symptoms (P<0.001), predisposing factors (P<0.004) and schistosomiasis control measures (P=0.003) between irrigators in Morogoro and Kilimanjaro traditional schemes. Conclusion: From the results it appears that the level of farmers’ knowledge of schistosomiasis is related to: proximity to health facilities of the community, trainings that have been provided to farmers and farmer’s literacy rate. However the government should be responsible to improve health facilities, construct roads and deliver schistosomiasis education to communities in irrigation areas even for schemes which have not been planned, designed and constructed by the government.