Snakebite envenomation is among neglected tropical diseases that continue to pose public health challenges especially in rural and poor communities of Africa including Tanzania. This study explored the risk factors and local practices regarding snakebite among communities in Kilombero Valley, South-east Tanzania. Participants involved were snakebites victims ≥ 18 years, parents for those aged < 18 and relatives of the deceased victims. Participants were obtained through local leaders followed by snowballing technique. Structured questionnaire was used to investigate the risk factors, first aid, and management practices. Additionally, in-depth interviews with traditional healers explored the community practices on first aid and treatment provision upon exposure to snakebites. A total of 233 snakebite victims and 3 traditional healers were traced and interviewed. The majority of snakebite cases reported to occur in the evening (61%). Most snakebite cases occurred in rainy season (66%) and in the farms (33%). A large percentage of the victims (78%) reported having been bitten in the lower parts of the leg. Many snakebite victims (96.3%) received first aid with the use of a tourniquet above the wound (75%) as common approach. Over 50% of the victims reported seeking treatment from traditional healer, with easy access (65%) to traditional healers reported as motivation factor. Snakebite envenomation is common in the study area. Community awareness on the prevalent of snakebites and associated risks is essential. Additionally, one health approach integrating traditional healers into health systems may improve case management.