Dissertation (MSc Nursing Education)Background: The number of elderly population has increased from 2% in 2002 to 5% in 2012 in Zanzibar. According to our health care delivery system nurses are the key care providers to older people with acute and chronic diseases. This study was proposed to assess the knowledge level, attitude and their predictors towards elderly care among nursing students in Zanzibar. Method: It was a cross-sectional study. Three nursing training institutions from Zanzibar were selected by using simple random sampling; total sample size was 393 diploma nursing students. A tool adopted from Palmore (FAQ2) was used to asses knowledge, the score was categorized as 50% good knowledge. The attitudes was assessed by a four point Likert scale adopted from Kogan range from strongly agreed to strongly disagreed the categorization was ≤ 47 negative attitude and >47 positive attitude. Bivariate and multivariate logistic regression was used. Results: More than half of respondents were female 274 (69.7%); mean age was 22.38 ± 1.95 years, ranges from 18-33 years. The majority of respondents 324 (82.4%) scored in the poor category of knowledge. 267 (67.9%) had positive attitudes. Factor that was found to predict good knowledge was, those students who had experience of elderly caring in their clinical nursing practice were 11.247 (AOR) more likely to have good knowledge (p0.01, CI 1.86; 3.65). However, there was no significant association between the attitude of the respondents and knowledge (χ2=0.395, p=0.395). Conclusion: Generally respondents had poor knowledge and positive attitudes. Experience of elderly care during clinical practices and type of institution were associated with knowledge whereby type of residence and living in extended family were associated with attitudes. Living with an elderly at home was associated with both knowledge and attitudes.