Purpose: Following baseline surveys in Tigray region in 2013. Since then, rounds of azithromycin mass drug administration (MDA) have been delivered in line with international guidance. The purpose of these surveys was to assess TF prevalence following those treatments to enable the region to plan the next steps towards elimination of trachoma. Methods: All surveys followed WHO recommendations for community-based cross-sectional survey design. 31 woredas in 6 zones of Tigray region were surveyed. There were two survey series: all 31 woredas were surveyed in the first series of surveys, and 11 woredas were resurveyed in the second. 20 woredas had one survey and 11 woredas had two surveys in the reported period. Results: In the first series of 31 surveys, one woreda had an adjusted TF prevalence in 1−9-year-olds of <5.0%, 13 had a prevalence of 5.0−9.9% and 17 had a prevalence of 10.0−29.9%. In the second series of 11 surveys, the prevalence of TF was <5.0% in seven woredas and 5.0−9.9% four woredas. The most recent adjusted prevalence of trachomatous trichiasis (TT) unknown to the health system in ≥15-year-olds was ≥0.2% in 27 EUs. One-third of households visited had access to an improved drinking water source within a 30-minute return journey of their house and 11% had an improved latrine. Conclusion: Eight EUs met the criteria to stop MDA for two years before re-survey. However, further rounds of MDA, additional efforts to improve water and sanitation access and ongoing strengthening of surgical services for TT are needed across Tigray.