Full text article. Also available at https://doi.org/10.1371/journal.pone.0210350Chronic respiratory diseases in Tanzania are prevalent and a silent burden to the affected population, and healthcare system. We aimed to explore the availability of services and level of health facilities readiness to provide management of chronic respiratory diseases and its associated factors. Methods: The current study is a secondary analysis of the 2014–2015 Tanzania Service Provision Assessment Survey data. Facilities were considered to have a high readiness to provide management of chronic respiratory diseases if they scored at least half (50%) of the indicators listed in each of the three domains (staff training and guideline, equipment, and basic medicines) as identified by World Health Organization-Service Availability and Readiness Assessment manual. Descriptive, unadjusted and adjusted logistic regression analyses were performed. A P value < 0.05 was taken to indicate statistical significance. Results: Out of 723 facilities included in this analysis, approximately one-tenth had a high readiness to provide management of chronic respiratory diseases. Less than 10% of the facilities had at least one staff who received training for management of chronic respiratory diseases. In anadjusted model, privately owned facilities [AOR = 3.3; 95% CI, 1.5–7.5], hospitals [AOR =11.6; 95% CI, 5.0–27.2], health centres [AOR = 5.0; 95% CI, 2.4–10.7], and performance of routine management meeting [AOR = 3.3; 95% CI, 1.4–7.8] were significantly associated with high readiness to provide management for chronic respiratory diseases. Conclusion: Majority of Tanzanian health facilities have low readiness to provide management for chronic respiratory diseases. There is a need for the Tanzanian government to increase the availability of diagnostic equipment, medication, and to provide refresher training specifically in the lower-level and public health facilities for better management of chronic respiratory diseases and other non-communicable diseases.