There is a paucity of studies that have systematically and comprehensively investigated the knowledge level, attitudes and the pattern of sexual behaviours related to HIV and AIDS in higher education settings in sub-Saharan Africa in general and Tanzania in particular. This study attempted to fill a void in knowledge. A cross-sectional descriptive design was used, employing a self-administered questionnaire as the main data collection tool. More than 400 higher education students completed a questionnaire assessing their knowledge, attitudes and behaviours related to HIV and AIDS. About three quarters of respondents demonstrated comprehensive knowledge about HIV and AIDS, and the majority of respondents expressed positive attitudes towards people living with HIV and AIDS. Despite demonstrating high knowledge level about HIV and AIDS, the results show that sexual behaviours among students in higher education are characteristically risky, and do not significantly differ from youth in the general population.