Menstrual hygiene management was studied in 12 secondary schools of Kinondoni and Bagamoyo district in Tanzania. The schools were selected by cluster sampling technique among public and private schools. Data were collected through questionnaire, Focus Group Discussion (FGD), semi-structured interviews and guide checklist for observation. A total of 149 girls participated in the survey and out of them, 84 participated in the FGD. A total of 23 head/deputy head of schools and matrons participated in semi-structured in-depth interview. The information sought included menstrual hygiene management (MHM) facilities, practices and education. The results indicate that all surveyed schools offered some sort of MHM education to girls and 3 schools out of 9 co-education schools involved in the study, provide some education about MHM to boys. A large majority of girls still need more information on MHM and prefer this information be provided at school. Lack of soap, hand wash facilities, privacy in toilet and free pads to attend emergency needs were identified as main problems. A supportive environment for MHM has to be provided in schools and to achieve this; instruction about MHM should be incorporated into compulsory health education in both primary and secondary schools curricula with separate sessions for girls and boys. Moreover, there is an urgent need for girl’s friendly toilet designs and appropriately final disposal facilities for menstrual products in schools. The efforts do not always mean large investments in infrastructure but in many instances, it suffices with just small investment.