Introduction: Motorcycles have become a popular choice of transport in Tanzania, hence there is an increase in motorcycle crashes. Considering the high rate of motorcycle crashes, magnitude and seriousness of the injuries in the head and neck region, studying the pattern of maxillofacial injuries in motorcycle crash victims (MCV) is inevitable. The aim of the study was to investigate the occurrence, types, and treatment of maxillofacial fractures in MCV at Muhimbili, a tertiary national hospital in Tanzania. Materials and methods: This was a descriptive, cross-sectional, and hospital-based study that included all MCV. These were received, interviewed (including the use or nonuse of helmets and alcohol intake), physically examined, and investigated for maxillofacial injuries. Maxillofacial fractures were categorized as mandibular, midface, and upper third of face (frontal) fractures. Management of the injuries included supportive, medical, and surgical treatment. The data were analyzed using Statistical Package for Social Sciences (SPSS) Version 20. Results: A total of 116 MCV predominantly (113, 97.4%) men were included in this study with a male-to-female ratio of 37.7:1. The crash victims were aged between 14 years and 66 years (mean of 29.43 ± 8.88), and the 20 years and 39 years age group was the most affected. More than half (53.4%) of the victims had not put on helmets and only 18.1% of the victims were under the influence of alcohol during the crashes. The majority (89.7%) of MCV sustained maxillofacial fractures whereby 71.2% had mandibular fractures, 66.3% had midface fractures, and 9.6% had frontal bone fractures. The severity of injuries significantly correlated with the speed of motorbikes during crashes. Maxillomandibular fixation (MMF) was the commonest treatment modality of the fractures employed. Conclusion: The findings of this study revealed that young men (14–39 years) were more prone to motorcycle crashes. The majority of MCV did not wear helmets and only a few were under the influence of alcohol during the crashes. The mandible and zygoma were the frequently fractured bones and the odds of multiple fractures increased with increased speed of motorbikes. Clinical significance: The results of this study cast light on the pattern and burden of oral and maxillofacial injuries in Tanzania, thus serving as the basis for future interventions to improve the injured patient outcomes, and reduce morbidity and mortality. The information obtained from this study can be used by public health researchers to improve health policies on road traffic crash prevention.