The aim of this study was to evaluate the radiation doses to patient during chest and abdomen CR examinations, and assess the related level of optimization at five referral hospitals in Tanzania. The international code of practice for dosimetry in diagnostic radiology was applied to determine the entrance surface air kerma (ESAK) to patients. The level of optimization was assessed from low-contrast objects scores of phantom images at different exposures. The results show that mean ESAK varied from 0.16 to 0.37 mGy for chest PA and from 2 to 6 mGy for abdomen AP. Assuming similar patient and phantom attenuations, the optimization performed at all facilities was consistent with phantom evaluations in terms of tube potential settings in use. However, all facilities seemed to operate at higher tube load values above 5 mAs for chest examination, which can lead to unnecessary patient doses. Inadequate initial training on CR technology explains in large proportion the inappropriate use of exposure parameters.