This article offers a review of published texts describing sexual relations between men in Tanzania in the period 1860–2010. It explores ways in which men who have sex with men have been named and understood; describes the sexual and social roles associated with differing same-sex identities and subjectivities; tracks politics, policies, and sociocultural expressions relating to sex between men; and explores the ways in which men’s same-sex sexual practices have been responded to in the context of health and HIV. Among the impressions emerging from the historical record is that sex between men is not (and has not been) uncommon in Tanzania; that a significant conceptual distinction exists between men who are anally receptive and men who penetrate anally; and that there has been a range of views on, and opinions about, same-sex relations within the wider society. There is evidence that same-sex practicing men in Tanzania have been affected by HIV at least since 1982, with one seroprevalence study indicating that the burden of HIV among men who have sex with men was quite disproportionate as far back as 2007. However, while men who have sex with men have been defined as a “vulnerable population” with respect to HIV in national frameworks since 2003, this had not led to any significant amount of targeted HIV prevention work being reported by either local or international actors by 2010.