This study assesses the effect of access to extension services on the Technical Efficiency (TE) of Smallholder Sugarcane Farmers (SHSCFs) in Kilombero valley, Tanzania. Based on a crosssectional survey of 274 randomly selected SHSCFs, the study compared the Cobb-Douglas (CD) and translog frontier models and selected CD which fitted well in the dataset. The Propensity Score Matching (PSM) method was then applied to determine the effect of extension service access on TE. The estimated mean technical efficiency is 60%, suggesting that there is room for improving efficiency in the use of production inputs at the disposal of SHSCFs. Furthermore, based on the propensity score matching method, the analysis indicates that access to extension services generates a positive and significant differential effect on technical efficiency. As such, policies are needed to strengthen the institutions providing extension services in order to not only ensure availability and make them readily accessible but also improve the quality of the services provided. Limitations and avenues for further research are also highlighted