Introduction The intrauterine device (IUD) represents the most cost-effective, long-acting reversible form of contraception, but accounts for only 1% of all contraception methods used in Tanzania. Objective This study aims to determine the uptake of IUD use and investigate the perceptions, challenges, and recommendations surrounding the use of intrauterine devices among women of reproductive age in Tanzania. Method A cross-sectional study was conducted including 347 women, as well as qualitative semi-structured interviews with 11 women. Quantitative data were entered into SPSS, and descriptive statistics were employed to summarize the data. Content analysis was used to analyse the qualitative data. Results The prevalence of IUD use was 5%. The majority of the women interviewed were aware of myths and misconceptions concerning IUDs but wanted to use it after receiving information from healthcare providers. Conclusion The study found that the use of intrauterine devices was low in the study area and that there is a need to strengthen community engagement to reduce misconceptions about the use of IUDs.