The purpose of the study was to evaluate the quality control (QC) tests results of general radiography x-ray equipment in order to assess the performance of the x-ray equipment in comparison to the acceptance limits, hence advise on measures to provide quality diagnostic imaging at optimized dose. QC tests results from health facilities in Mtwara and Lindi regions were evaluated. The QC results from 2015 to 2021 were analyzed for   selected QC parameters which included kV accuracy, kV reproducibility, mAs linearity, beam quality, collimation and beam alignment. All x-ray units passed the kV accuracy, kV reproducibility, and beam quality and beam alignment tests.  It was noticed that the collimation test surfaced among the failed parameters, though the performance of all the tested parameters were within 76.9 %. to 100% of the acceptable limits. Furthermore, lack of QC and maintenance plan was noted. Generally, the performance of most of the x-ray units were in   compliance with regulatory requirements. However, improvement is desirable especially in the areas of QC plan, preventive maintenance and repair. Managers of the facilities need to take heed that optimum equipment       performance is vital if quality imaging at optimized radiation dose is to be realized.