Upper respiratory tract infection occurs commonly in both children and adults and is a major cause ofmorbidity worldwide. Inappropriate antibiotic prescription for upper respiratory tract infections isassociated with increasing antibiotic resistance, healthcare costs, adverse events, and poor patientoutcomes. The objective of this study was to determine physician prescription practices of antibioticsfor upper respiratory tract infections at Kilimanjaro Christian Medical Center hospital in Moshi,Tanzania. This was a retrospective hospital-based cross sectional study which systematically sampled files of patients with diagnosis of upper respiratory tract infection. Information from a total of 300patients’ prescriptions were collected, reviewed and analyzed. The most common infections diagnosis was non-specific upper respiratory tract infections accounting for 102 (34.0%) followed by rhinitis andtonsillitis both accounting for 52 (17.3%) with the least being common cold 22 (7.3%). Antibiotics wereprescribed to 200 (66.7%) patients with upper respiratory tract infections. Amoxicillin alone was themost preferred drug for all upper respiratory tract infections 91 (31.5%). In the multivariable logisticregression analysis, patients with cough and running nose (AOR=16.41, 95% CI: 1.95-138.19) had higherodds of being prescribed with antibiotic as compared to those without such symptoms (AOR=1.98, 95%CI: 1.04-3.77), respectively. Antibiotics are being over-prescribed among patients with upper respiratorytract infection. Interventions to reduce the over-prescription and hence overuse of antibiotics for upperrespiratory tract infections are urgently needed.