Introduction: An impacted tooth is the one which fails to attain its normal functional position within the expected developmental period. They are associated with various pathologies. Hence, the aim of this study was to determine the pattern of occurrence, presentation, and management of impacted teeth among patients attending Muhimbili National Hospital. Materials and Methods: This was a cross-sectional hospital-based study that included all patients aged≥21 years and had impacted teeth. The patients were interviewed using a specially designed questionnaire and later examined clinically and radiographically. Data obtained was an- alyzed using SPSS version 23.0. Results: A total of 4,668 patients comprising of 1938 (41.5%) males and 2730 (58.5%) females were attended. Among these, 264 (5.6%) patients comprising of 152 (57.6%) males and 112 (42.4%) females had impacted teeth. The 21-25 years age group was the most (59.2%) commonly affected. Mandibular third molars were the most (64.9%) impacted teeth followed by 167 (33.4%) maxillary third molars. Pain was the most common complaint in 79.1% of patients. Mesio-angular impaction was the most common angulation in 196 (39.9%) impacted teeth, followed by vertical impaction in 142 (28.7%) and disto-angular 103 (21.0%) impacted teeth. A majority (66.6%) of impacted teeth were treated by open surgical removal followed by 53 (10.5%) impactions by closed disimpaction. Conclusion: The occurrence of impacted teeth among the patients attended at MNH was 5.6%. Mandibular third molars were the most commonly impacted teeth with mesio-angular being the commonest type of angulation of impacted teeth. Pericoronitis was the most common pathology associated with impacted teeth, others included dental caries, ameloblastoma, and dentigerous cysts. Surgical disimpaction was the most frequently used treatment method with good healing results.