PredictionmodelsindicatethatmelioidosismaybecommoninpartsofEastAfrica,buttherearefewempiricdata. We evaluated the prevalence of melioidosis among patients presenting with fever to hospitals in Tanzania. Patientswith fever were enrolled at two referral hospitals in Moshi, Tanzania, during 2007–2008, 2012–2014, and 2016–2019.Blood was collected from participants for aerobic culture. Bloodstream isolates were identified by conventional bio-chemicalmethods.Non–glucose-fermentingGram-negativebacilliwerefurthertestedusingaBurkholderiapseudomalleilatex agglutination assay. Also, we performedB. pseudomalleiindirect hemagglutination assay (IHA) serology on serumsamples from participants enrolled from 2012 to 2014 and considered at high epidemiologic risk of melioidosis on thebasis of admission within 30 days of rainfall. We defined confirmed melioidosis as isolation ofB. pseudomalleifrom bloodculture, probable melioidosis as a³4-fold rise in antibody titers between acute and convalescent sera, and seropositivityas a single antibody titer³40. We enrolled 3,716 participants and isolated non-enteric Gram-negative bacilli infive (2.5%)of 200 with bacteremia. As none of thesefiveisolates wasB. pseudomallei, there were no confirmed melioidosis cases. Of323 participants tested by IHA, 142 (44.0%) were male, and the median (range) age was 27 (0–70) years. We identified two(0.6%) cases of probable melioidosis, and 57 (17.7%) were seropositive. The absence of confirmed melioidosis from 9years of fever surveillance indicates melioidosis was not a major cause of illness.