With the availability of modern workstations and heightened awareness of the Health services cost and environmental effects of waste anaesthesia gases, anaesthesia providers worldwide are practicing low flow anaesthesia. In most developing countries Low Flow Anaesthesia is still underutilized due to lack of monitoring equipments and sufficient knowledge. Tanzania appears to have a paucity of studies on the prevailing practice pattern of fresh gas flow. Objective; The study aimed at assessing the practice of low flow anaesthesia and volatile agents choices among anaesthesia providers at Muhimbili national hospital and Muhimbili orthopaedic institute. Methods: A descriptive cross-sectional study was carried out for a period of 8 months involving 158 anaesthesia providers. A Structured questionnaire was used to collect data which included demographic, practice setting of Low Flow Anaesthesia, Workstations, scavenging, monitoring equipments, Volatile agents routinely used and preferred Agent. Data were analysed using the IBM Statistical package for social science’s version 23.0. Result: Prevalence of Low flow anaesthesia was 27.2%, however, only 6% used the fresh gas flow of 1l/min – 500mls/min. All anaesthesia providers had workstations and only 2.3% displayed Minimum Alveolar concentration (MAC), 79.1% worked in theatre with functioning scavenging systems, 55.8% used capnography, 6.9% monitored inspiratory Oxygen and none of anaesthesia providers used Bispectral and Agent Analyzers. Isoflurane was the most routinely used inhalational agents (100%) followed by Sevoflurane (69%), then Halothane (32%). Desflurane still not available in these hospitals. Conclusion: Low flow anaesthesia is seldom practiced in our locality despite having strong evidence of attractive advantages in medical practice and ergonomics.