The adoption of Electronic Medical Records Systems (EMRs) is on the rise in developing countries due to the need to ensure improved quality of healthcare through client continuum and monitoring and information sharing through collecting detailed, good quality and reliable information overtime. In spite the benefits of EMRs, their success depends on use and satisfaction of users with the system. Recently National Tuberculosis and Leprosy Program of Tanzania adopted an EMRs known as the DHIS2 Tracker to help with case management, improve reporting and reduce lost to follow-up cases.This study therefore aimed to investigate factors influencing use and user satisfaction of DHIS2 Tracker by adapting both the DeLone & McLean Model with the Technology Acceptance Model. The research model consisted of six factors from which an online questionnaire using Google forms was developed and shared with users of the system. In order to assess the relationship between factors, nine hypotheses were developed and multiple regression analysis was conducted.The analyzed data supported five out of nine hypotheses and indicates that system quality and attitude have positive significant influence on both system usage and user satisfaction, while use of the system has a positive significant influence on satisfaction. However, user background and information quality do not have significant influence on either use or satisfaction of DHIS2 Tracker. These findings help implementers understand areas of focus during implementation of DHIS2 Tracker.