Introduction <p>Adolescents’ sexual health awareness and condom knowledge are critical in shaping sexual behaviors. However, gaps in understanding may increase risky sexual behaviors resulting to HIV infections and unintended pregnancies. This study examined the influence of sexual health awareness and condom knowledge on risky sexual behaviors among primary school adolescents in Tanzania.</p> Methods <p>A cross-sectional study was conducted among 400 primary school adolescents. Structured questionnaires assessed sexual health awareness, condom knowledge, and engagement in risky sexual behaviors. Logistic regression analyses identified predictors of risky sexual behaviors.</p> Results <p>Most adolescents (78%) demonstrated low sexual health awareness, indicating limited understanding of sexual risks, including early sexual initiation, multiple partners, and consequences such as HIV and unintended pregnancies. In contrast, 72% exhibited high condom knowledge, reflecting awareness of its protective benefits. Only 14% of adolescents reported engagement in risky sexual behaviors. Logistic regression showed that sex was a significant predictor: females were 76% less likely than males to engage in risky behaviors (OR = 0.24, <i>p</i> &lt; .001). In contrast, age, sexual health awareness, and condom knowledge were not significant predictors of risky sexual behavior (age: OR = 1.6, <i>p</i> &gt; .05; sexual health awareness: OR = 1.04, <i>p</i> &gt; .05; condom knowledge: OR = 0.541, <i>p</i> &gt; .05).</p> Conclusions <p>The study highlights the need for early, comprehensive sexuality education to foster protective behaviors among adolescents. Integrating gender-sensitive and age-appropriate sexual health programs into primary school curricula can inform policies that reduce adolescent risky sexual behaviors and promote safer sexual behaviors.</p>