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China’s medical assistance to Africa has attracted relatively little attention from scholars compared to other forms of assistance such as economic and political. “A Historical Study of China’s Medical Assistance in Post-Colonial Tanzania” examines the implications of Chinese assistance in the development of Tanzania’s health sector under the discourse of South-South cooperation. Through the use of archival and other documentary sources collected in Tanzania, China, and Switzerland, as well as oral histories, this study explores how China’s medical assistance reflected the Southern agenda of promoting self-reliance and lessening the dominance of Northern countries in medical aid and knowledge in the South. It illuminates social, economic, and political contexts that gave birth to China’s medical assistance in Tanzania. The study shows that, after the Arusha Declaration of 1967, the Tanzanian government adopted Chinese health policies such as free health care, the institutionalisation of traditional medicine, and rural health care. It argues that the adoption of Chinese health policies contested the conceptions of the production and transmission of knowledge from the North “core” to the South “periphery”. Consequently, the practices of Chinese health policies in Tanzania signal the realisation of knowledge production and exchange from the periphery to the periphery. Indeed, as the study shows, the independent Tanzanian government aspired to become self-dependent. Such endeavours grew in the mid-1960s, following its diplomatic rifts with traditional donors of the North. Under idealistic motives of Southern solidarity, it perceived Chinese aid as a bridge to self-reliance, and indeed, this was the “vision” of the Chinese government as is evident in its foreign aid principles. In the same vein, the Chinese-funded health projects, such as the medical team program, were expected to build the capacity of Tanzania’s health sector through medical knowledge production and exchanges with local medical workers. The Chinese-sponsored pharmaceutical industries were planned to maintain the local production of pharmaceuticals and ensure imports, while traditional Chinese medicine research and treatment projects were expected to boost medical knowledge among local researchers and practitioners. Nevertheless, this study argues that China’s medical assistance to post-colonial Tanzania was hampered by several drawbacks, which affected its efficiency and sustainability, hence failed to realise the country’s anticipated self-reliance. Contrary to the government’s expectations, the assistance created unforeseen dependences on Chinese medical doctors, pharmaceutical raw materials, traditional Chinese medicine, and pharmaceutical technicians sent from China. Findings of this study show that most of the medical projects declined in the absence of Chinese assistance. Such circumstances warrant the conclusion that despite the merits of China’s aid, especially in counteracting the dominance of medical aid and knowledge from the North, its assistance hardly functioned as a sustainable solution to health challenges that faced the Tanzanian government. Admittedly, the medical assistance functioned as a soft way of securing allies during the Cold War era and a vital tool in maintaining China’s political and economic interests.