This document examines the determinants of financial sustainability of microfinance institutions (MFIs) in East Africa from 2004 to 2009. It uses regression analysis to analyze data from 23 MFIs. The key findings are that MFI sustainability is positively associated with loan intensity and size, but negatively associated with management inefficiency and portfolio at risk levels. Breadth of outreach and deposit mobilization did not significantly impact financial sustainability. Thus, loan intensity, size, management efficiency and loan portfolio quality are important factors influencing the financial sustainability of MFIs in East Africa.