Identifying and implementing interventions that create co-benefits in terms of food and nutrition security as well as food safety requires an interdisciplinary and intersectoral approach. This study was part of a larger project that applied an integrated framework for combined nutritional, food safety and value chain analysis to assess the dairy value chain in two regions of Tanzania, namely Morogoro and Tanga. Here, we report on the use of participatory rural appraisals (PRAs) with producers and consumers to investigate seasonality, constraints and opportunities in cow milk production and consumption in ten villages in Tanzania and describe attitudes and practices surrounding milk quality and safety. The PRAs allowed identifying strong seasonal milk production and consumption practices reflecting rainfall patterns and a dependence on the natural environment. A wide range of production constraints were described by producers including insufficient technical know-how, poor quality breeds, cattle diseases, lack of capital, feed, water and reliable markets. While milk availability had a strong influence on milk consumption, findings showed that there are a range of other factors such as the consistency of milk, purchasing power and the availability of other foods which also influence consumer choice. A dependence on sensory milk quality attributes in the absence of other systems of certification was described. Both producers and consumers showed little concern regarding potentially contaminated milk despite an awareness of the existence of milkborne disease risks. The results indicate great potential for upscaling dairy production and at the same time highlight that any such interventions should carefully consider mitigation measures for food safety risks.