This study assessed the geographic distribution and characteristics of fish consumption among residents of Mwanza Region, Tanzania. It was conducted in four districts: Ilemela, Magu, Misungwi and Kwimba. A total of 1,200 respondents participated in assessing fish consumption patterns, species preferences, purchasing behavior, and factors influencing consumption. Data were analyzed using conjoint analysis, preference assessment index, and discriminant analysis. The consumer profile showed that 82.33% of respondents were aged 18–50 years, while only 7.50% held a college degree, indicating a young population with limited formal education. Over 65% reported regular fish consumption, highlighting the important role of fish in local diets. Increased availability (62%), accessibility (52%) and affordability (48%) were major factors contributing to fish consumption. Roadside markets (32.63%) and retail markets (29.86%) were the most preferred purchasing points, while landing centers accounted for 17.85%. Tilapia was the most preferred species, followed by Nile perch and other carps, largely because of consistent availability and local familiarity. Major barriers included erratic availability, limited access, price fluctuations, and high prices during peak demand. Socioeconomic, market, and accessibility factors influenced consumption patterns. Improving fish availability, affordability, distribution systems, and market accessibility could increase fish consumption and contribute to improved nutrition and food security. The findings provide useful evidence for fisheries managers, policymakers, traders and stakeholders in promoting sustainable fish supply and equitable access