Water supply is a mandatory service for Tanzanians from respective legal public water utilities, and their sustainability reflects implementations of best management strategies at a local level. The objective of this study was to assess current approaches used in water quality and quantity management in Tanzania. This was achieved through secondary water data tends, on-site water quality assessments, visits of respective water supply and sanitation authorities, and assessment of their performances. It was observed that water supplied in rural-based authorities was quite different from that supplied in an urban setting as far as quality and quantity is concerned, urban-based supplies being of assistance to users over rural ones. A new strategy on water management is presented for sustainable water supply in Tanzania; it is based on controlling groundwater abstractions and preference of surface water in public water supplies. Rural water supply management must learn several practices realized at urban supplies for the betterment of respective majority water users.