One Health, or the holistic approach of viewing human, animal and ecosystem health as interconnected, can play an important role in developing solutions to address diverse health challenges. For young people to grasp contemporary societal and planetary challenges, this understanding is critical. Using data collected through a classroom activity and an iterative coding approach, I analyzed art and written elements developed by primary school students in a biodiverse, rural region of Tanzania to explore their understanding of links among the health of people, animals, and local environments. The students perceived human health in an expansive way, tying it to the health of domestic animals and wildlife, water sources, forests, and ecosystems. They drew varied connections, identifying both direct and indirect impacts on their own health, as well as the broader health of their communities. The students made connections at microscopic and landscape levels, including issues of polluted water and disease and impacts of forests on rainfall and drought. Learning how students understand these connections can aid the efforts of teachers and environmental and health educators in the region, as well as inform curriculum development for students in Tanzania, East Africa, and beyond.