OBJECTIVE: To determine risk factors for bacterial vaginosis (BV) among women working in the bars and hotels in Moshi, Northern Tanzania. RESULTS: Severe disturbances of vaginal flora or BV were detected in 70/268 (26.1%) women (95% confidence interval (CI): 20.8%-31.4%). In multivariate analyses, religion was the only socio-demographic characteristic that remained significantly associated with BV. Other independent predictors of BV were Trichomonas vaginalis (adjusted odds ratio (OR)=2.7, 95% CI: 1.4-5.3), Chlamydia trachomatis (adjusted OR=3.5, 95% CI: 1.2-10.6), syphilis (adjusted OR=7.1, 95% CI: 41.1-4.7) and herpes simplex virus type 2 (HSV-2) infection (adjusted OR=1.8, 95% CI: 1.0-3.3). CONCLUSION: Bacterial vaginosis (BV) was the common cause of genital symptoms in the study population. Since sexually transmitted diseases (STDs) were strongly associated with BV, control of STDs and BV should be given the highest priority in this population