The trend and predictors of infertility are not well known in sub-Saharan Africa. A nationally representative Demographic and Health Survey (TDHS) was conducted in Tanzania in 1991/92, 1996 and 1999, enabling a trend study of infertility. Logistic regression was used to determine the predictors of infertility. The prevalence of primary infertility was about 2.5%, and secondary infertility was about 18%. There was no change between the 1991/92, 1996 and 1999 TDHS. The risk of primary infertility was higher in the Dar es Salaam and Coast regions than in other regions and secondary infertility was higher in the Dar es Salaam region. The Dar es Salaam and Coast regions are known for also having elevated levels of HIV/AIDS. Because sexual practices and sexually transmitted diseases are strong predictors of pathological infertility and HIV infection in Africa, we recommend that concerted efforts be made to integrate the prevention of new incidences of infertility with the HIV/AIDS campaigns.