BACKGROUND: Early sexual initiation among female youth in Tanzania presents a significant public health concern, as it is associated with increased risks of unintended pregnancies, sexually transmitted infections and adverse socioeconomic consequences. This study aimed to determine the prevalence and associated factors of early sexual initiation among female youth in Tanzania. METHODS: We used data from the 2022 Tanzania Demographic and Health Survey, conducted between February 24 and July 21, 2022. The sampling frame was stratified by geographic region and urban/rural areas, using a two-stage sampling method that selected primary sampling units based on census enumeration areas, followed by household selection using probability systematic sampling. Data management and analysis were performed using STATA version 18.5, descriptive statistics, and a weighted logistic regression model to determine factors associated with early sexual initiation. Odds ratios (OR) and 95% Confidence intervals (CI) were used to estimate the strength of association. RESULTS: The overall prevalence of early sexual initiation among female youth in Tanzania was 17.4%. In an adjusted analysis, female youth with no formal education had higher odds of having early sexual initiation (aOR = 3.09, 95%CI: 2.06-4.57) compared to their counterparts who had attained secondary/higher education. Conversely, female youth who were working (aOR = 0.81, 95%CI: 0.62-0.97), having media exposure (aOR = 0.74, 95%CI: 0.58-0.96), and increased in age (aOR = 0.91, 95%CI: 0.87-0.96) were associated with lower odds of having early sexual initiation. CONCLUSION: This study found a significant proportion of female youths who had early sexual initiation. Lack of education, increase in age, media exposure, and employment were associated with early sexual initiation. There is a great need for a multifaceted approach that includes educational reforms and comprehensive economic strengthening while addressing structural inequalities that increase sexual vulnerability in addressing early sexual debut among female youths..