This study provides evidence on the specific nature and experiences of people with disabilities and older people from their own perspectives in rural and urban settings in Tanzania. Its aim was to better inform efforts to provide services for and improve the lives of people living in those regions. A community-based participatory approach was used, involving collaboration with the community. Peer researchers and research partners collected and analysed interviews with people with disabilities and older people, leading to policy and advocacy recommendations and early stage plans. Findings demonstrate how lack of access to healthcare and education, social limitations and powerful community attitudes were interwoven and exacerbated poverty in these contexts. Policy recommendations cover issues such as halting persecution and killings of people with albinism, support and guidance for families of children with disabilities, national policy on ageing legislation, and implementing and monitoring the UN Convention on the Rights of Persons with Disabilities.