Female Genital Schistosomiasis (FGS) is among the neglected gynecological manifestation of urogenital schistosomiasis in Tanzania. Little is known about the challenges in the diagnosis, treatment, and prevention of FGS in Tanzania. The challenges could potentially threaten the successful control of the FGS. Therefore, the letter explains the challenges in the FGS management and recommends the appropriate measures that could be taken to initiate the fight against the FGS in Tanzania. The challenges included; the unknown magnitude of FGS in the country, lack of diagnostic equipment in most of the health centers, limited capacity of the healthcare worker for the diagnosis and treatment of FGS, poor awareness of women and girls on the FGS and urogenital schistosomiasis and lack of preventive chemotherapy targeting this group. The recommended measures are the establishment of the burden of FGS and urogenital schistosomiasis in the country, resources mobilization for buying diagnostic equipment, training healthcare workers on the use of diagnostic equipment, raising community awareness about FGS, provision of screening services and praziquantel preventive chemotherapy.