Abstract Antimicrobial resistance (AMR) is a complex global health threat driven by socio-demographic, economic, and systemic factors that contribute to drug misuse. In developing countries, inadequate healthcare, poor sanitation, and widespread poverty exacerbate this issue. Understanding these factors is crucial for designing targeted interventions. This study aims to (a) assess public awareness of AMR among residents of the Dodoma region, (b) identify common antimicrobial use practices, and (c) examine the influence of socio-economic factors on antimicrobial use and awareness. A cross-sectional study was conducted in the Dodoma region, where 450 participants from two districts were interviewed to collect data on AMR awareness and antimicrobial use practices. Chi-square tests were used to determine associations between categorical variables, while logistic regression was employed to identify factors influencing AMR awareness. Approximately 49% of the respondents were aware of AMR, and this variable was influenced by gender and education level, with females and respondents with higher education exhibiting greater knowledge of AMR. Drug misuse practices included sharing antimicrobials with family members (81.3%), self-medication (64.7%), and non-adherence to antimicrobial dosage (62.7%). Except for antimicrobial sharing, which was influenced by the level of income (with low income increasing the likelihood of sharing), the other antimicrobial use practices were not influenced by the socio-demographic and economic aspects of the respondents. The high rates of antimicrobial misuse practices suggest that increasing awareness of AMR and enhancing the availability of prompt healthcare services may play a crucial role in reducing these misuse behaviours.