We conducted a randomised community controlled trial to estimate the effectiveness of health and pig-management education intervention in reducing the incidence rate of porcine cysticercosis caused by Taenia solium in Mbulu District, northern Tanzania, between April 2002 and July 2004. We included a random sample of 827 pig-keeping households from 42 randomly selected villages in our 27-month study. We collected baseline data on the prevalence of porcine cysticercosis based on lingual examination of live pigs, and pig-management and sanitation knowledge and practices based on questionnaire interviews and observations. We allocated 21 of the villages to the health-education intervention, developed with community participation; we used stratified randomisation to balance the village-level baseline prevalence of porcine cysticercosis. From July 2003 to March 2004 following the intervention, we gave each participant household a sentinel piglet to raise (the timing was balanced between the intervention groups). Knowledge about the transmission and prevention of porcine cysticercosis was improved >42% in both groups when measured 10-12 months post-intervention. There was no improvement in observed practices in either group throughout the study period. However, the intervention had a significant reduction in the reported cases of household consumption of infected pork (a reduction by 20%). The intervention was associated with a considerable decrease in the incidence rate of porcine cysticercosis (incidence rate ratio 0.57) as measured by antigen-ELISA in sentinel pigs. Public education could lead to a reduction of the risk of infection in humans.