Fiscal gaps and donor dependency threaten the progress and sustainability of health programs in developing countries. This study aims to assess the acceptability and revenue generated from earmarked fuel levy for health in Tanzania. A survey was conducted in Dar es Salaam region in 2019 using a structured questionnaire. Survey data and fuel consumption rates were used to populate a decision-tree model to estimate revenues. The results were subjected to a one-way sensitivity analysis of plausible changes in key parameters. Analyses were done in Stata version 16.1 and TreeAge Pro ^® 2021. 400 participants were interviewed. 98 percent accepted earmarked fuel levy to finance health, of which two-thirds were willing to pay not more than 30 TZS (0.013 USD) per liter. A levy of 10 TZS/liter (0.004 USD) and 30 TZS/liter (0.013 USD) of diesel and petrol will generate 29 billion TZS (12.7 million USD) and 88.2 billion TZS (38.4 million USD), respectively. The fuel levy earmarked for health has the potential to generate significant revenues to finance healthcare in Tanzania.