Purpose: To estimate the incidence of suspected ocular surface squamous neoplasia (OSSN) by Region in Tanzania and learn where these lesions are treated.

Methods: We performed an analysis of existing theater records from three Tanzanian referral hospitals from 2006 to 2008 plus a prospective analysis of records from all other eye health workers who remove suspected OSSN outside the referral hospitals over 1 year.

Results: Approximately 40% of suspected OSSN are operated on outside of referral hospitals. The estimated annual incidence of ocular surface squamous neoplasia in Tanzania was 2.2 per 100,000 persons. Regional incidence rates were significantly correlated with Regional HIV (Human immunodeficiency virus) prevalence (Pearson’s r?=?0.53, P?=?0.03).

Conclusion: The incidence rate is high, in line with estimates from other East African countries. Management of these cases requires improvement as most patients are still not tested for HIV.