Abstract: In Tanzania, as elsewhere in the world, adolescent pregnancy and sexually transmitted infections are serious public health issues among youth. This study was conducted to assess the impact of self-help groups on access to sexual and reproductive health services and rights among youth in Mtwara and Lindi districts. Specifically, the study envisaged to (i) examine the availability and access to sexual and health reproductive services and rights among youth and (ii) examine the capacity of self-help groups in promoting access to sexual and health reproductive services and rights among youth in the study area. A cross sectional design incorporating a longitudinal perspective was used. Mixed methods of data collection were used, including organisational capacity assessment, focus group discussions, key informant interviews and documentary review. The findings show that most youth groups were conducting networking meetings and reaching over 7000 youth with sexual and reproductive health messages, and were members of the youth networks in their respective districts. These networks had helped to connect the youth with other youth in their villages, wards and districts, and had created forums for information sharing and articulation of different issues affecting their lives. The self-help groups have been very instrumental change agents in sexual and reproductive health issues in their communities through peer education, life skills, public meetings, festivals, sports and games. This has contributed to reducing the number of early and unwanted pregnancies, abortions and early marriages. Overall, the study has shown that youth self-group groups‟ approach is a very effective and powerful methodology for empowering youth socially, economically and politically.