Dissertation (MSc Midwifery)Introduction: Globally, by 2015 the maternal mortality ratio is estimated to be 216 per 100,000 live births. In Tanzania was approximately 556 per 100,000 live births; the leading cause was PPH approximately 25% of maternal deaths and uterine atony contributes 70% of PPH. These show that there are some limitations of knowledge and skills level on AMTSL among health care providers for prevention of PPH as it prevented more than 60% of PPH. Objectives: Assessment of knowledge and skills on active management of third stage of labour among health care providers for prevention of PPH in Lake Zone Tanzania. Methods: The research design was descriptive cross- sectional study. The study involved 340 participants who were obtained by convenient sampling. Regional, District hospital and health centers were selected by simple random technique, consultant hospital was purposefully selected. Data were collected using questionnaires and observational checklist. Results: The study found that, of all 340 participants, 171 (50.3%) had adequate knowledge, while 153(45.0%) had adequate skills on AMTSL among health care providers. Health care providers aged 45 years and above are (AOR 9.350,P< 0.009) times more likely to have adequate knowledge compared with health care providers aged below 25 years. Health care providers who works at hospital level are (AOR 1.779,P< 0.014) times more likely to have adequate knowledge than health care providers who works at health centres. On skills, male health care providers were 1.962(P< 0.009) times more likely to have adequate skills than female health care providers. Enrolled nurses have 70.2 % (P< 0.008) less likely to have adequate skills than medical Doctors. Conclusion: the magnitude of adequate skills on AMTSL is low, thus there is a need of improving the level of skills by clinical mentorship visits and bed side training to health care providers working in labour ward .